Provider Demographics
NPI:1417981408
Name:CUMBERLAND SPINE & JOINT REHABILITATION PLC
Entity Type:Organization
Organization Name:CUMBERLAND SPINE & JOINT REHABILITATION PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PRIETO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-905-0991
Mailing Address - Street 1:1750C MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4561
Mailing Address - Country:US
Mailing Address - Phone:931-905-0991
Mailing Address - Fax:931-905-0992
Practice Address - Street 1:1750C MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4561
Practice Address - Country:US
Practice Address - Phone:931-905-0991
Practice Address - Fax:931-905-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40917208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty