| Columbus Joint Pain Solutions And Functional Medicine, Llc | |
|
118 Enterprise Ct Ste A Columbus GA 31904-9228 | |
| (706) 330-1389 | |
| Not Available |
| Full Name | Columbus Joint Pain Solutions And Functional Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 118 Enterprise Ct Ste A, Columbus, Georgia |
| Authorized Official Name and Position | Chelsea Fountain (DIRECTOR) |
| Authorized Official Contact | 2295918216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Joint Pain Solutions And Functional Medicine, Llc 118 Enterprise Ct Ste A Columbus GA 31904-9228 Ph: () - | Columbus Joint Pain Solutions And Functional Medicine, Llc 118 Enterprise Ct Ste A Columbus GA 31904-9228 Ph: (706) 330-1389 |
| NPI Number | 1841056140 |
|---|---|
| Provider Enumeration Date | 02/23/2024 |
| Last Update Date | 02/23/2024 |
| Medicare PECOS PAC ID | 4688013782 |
|---|---|
| Medicare Enrollment ID | O20240423001480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841056140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RS0010X | Internal Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Katherine Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548650617 PECOS PAC ID: 3971821273 Enrollment ID: I20150417000322 |
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