Provider Demographics
NPI:1922304500
Name:VONORE PAIN MANAGEMENT
Entity Type:Organization
Organization Name:VONORE PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:RETHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:865-884-3400
Mailing Address - Street 1:1255 HIGHWAY 411
Mailing Address - Street 2:SUITE 6
Mailing Address - City:VONORE
Mailing Address - State:TN
Mailing Address - Zip Code:37885-2457
Mailing Address - Country:US
Mailing Address - Phone:423-884-3400
Mailing Address - Fax:423-884-3401
Practice Address - Street 1:1255 HIGHWAY 411
Practice Address - Street 2:SUITE 6
Practice Address - City:VONORE
Practice Address - State:TN
Practice Address - Zip Code:37885-2457
Practice Address - Country:US
Practice Address - Phone:423-884-3400
Practice Address - Fax:423-884-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain