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273 Highway 11 E Bulls Gap TN 37711-3433 | |
(423) 676-8400 | |
(423) 393-4344 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 273 Highway 11 E, Bulls Gap, Tennessee |
Authorized Official Name and Position | Charles L Backus (MEDICAL DIRECTOR) |
Authorized Official Contact | 4236768400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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273 Highway 11 E Bulls Gap TN 37711-3433 Ph: (423) 676-8400 | 273 Highway 11 E Bulls Gap TN 37711-3433 Ph: (423) 676-8400 |
NPI Number | 1104327360 |
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Provider Enumeration Date | 02/23/2018 |
Last Update Date | 02/23/2018 |
Identifier | Type | State | Issuer |
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1104327360 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |