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General NPI Number Information
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NPI Number | 1780147454
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Entity Type | Organization
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Legal Business Name | LOVELACE UNM REHABILITATION HOSPITAL LLC PAIN CLINC
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 500 WALTER ST NE STE 213
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-2543
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Country | US
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Telephone | 505-727-7177
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Fax | 505-727-3778
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Provider Business Mailing Address
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Address Line | 1 BURTON HILLS BLVD STE 250
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City | NASHVILLE
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State | TN
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Zip | 37215-6195
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Country | US
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Telephone | 615-296-3000
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Fax | 615-296-6227
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Authorized Official
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Title or Position | EVP
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Name | STEPHEN C. PETROVICH
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Credential |
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Telephone | 615-296-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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