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General NPI Number Information
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NPI Number | 1922871094
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Entity Type | Organization
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Legal Business Name | PAIN JUNCTION BY KNEETIX, LLC
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 105 US -15 BUS
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City | FARMVILLE
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State | VA
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Zip | 23901
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Country | US
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Telephone | 434-420-0466
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 96
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City | RED HOUSE
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State | VA
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Zip | 23963-0096
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Country | US
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Telephone | 434-420-0466
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JEMILLE SMITH
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Credential | MD
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Telephone | 434-420-0466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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