Basic Information
| Provider Information | |||||||||
| NPI: | 1568853588 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TENNESSEE ORTHOPAEDIC ALLIANCE, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 270 E MAIN ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | GALLATIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370662990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152781673 | ||||||||
| FaxNumber: | 6152781672 | ||||||||
| Practice Location | |||||||||
| Address1: | 270 E MAIN ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | GALLATIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370662990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152781673 | ||||||||
| FaxNumber: | 6152781672 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2015 | ||||||||
| LastUpdateDate: | 02/12/2015 | ||||||||
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| AuthorizedOfficialLastName: | WADE | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6153296600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.