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General NPI Number Information
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NPI Number | 1710450309
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Entity Type | Organization
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Legal Business Name | RINOVA THE WELLNESS GROUP, PC
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 1315 EUCLID AVE STE E17
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City | BRISTOL
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State | VA
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Zip | 24201-3841
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Country | US
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Telephone | 615-879-8935
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Fax |
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Provider Business Mailing Address
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Address Line | 314 COOL SPRINGS BLVD STE 100
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City | FRANKLIN
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State | TN
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Zip | 37067-6420
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Country | US
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Telephone | 615-879-8935
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | BENJAMIN W JOHNSON
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Credential | MD
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Telephone | 423-845-4296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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