Provider Demographics
NPI:1730460411
Name:ADVANCED PAIN THERAPEUTICS OF KNOXVILLE, TN LLC
Entity Type:Organization
Organization Name:ADVANCED PAIN THERAPEUTICS OF KNOXVILLE, TN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CREWS-FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-633-9469
Mailing Address - Street 1:900 E WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4511
Mailing Address - Country:US
Mailing Address - Phone:865-633-9469
Mailing Address - Fax:
Practice Address - Street 1:900 E WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4511
Practice Address - Country:US
Practice Address - Phone:865-633-9469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty