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General NPI Number Information
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NPI Number | 1902247471
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Entity Type | Organization
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Legal Business Name | BE WELL, PLLC
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 5115 MARYLAND WAY
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City | BRENTWOOD
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State | TN
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Zip | 37027-1200
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Country | US
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Telephone | 615-377-0773
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Fax | 615-250-9822
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Provider Business Mailing Address
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Address Line | 5115 MARYLAND WAY
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City | BRENTWOOD
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State | TN
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Zip | 37027-1200
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Country | US
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Telephone | 615-377-0773
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Fax | 615-250-9822
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Authorized Official
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Title or Position | OWNER
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Name | DR. CATHERINE R STALLWORTH
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Credential | MD
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Telephone | 615-377-0773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 25558
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License Number State | TN
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