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2214 E Fairview Ave Johnson City TN 37601-2860 | |
| (423) 928-6464 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Early Intervention Provider Agency |
| Location | 2214 E Fairview Ave, Johnson City, Tennessee |
| Authorized Official Name and Position | Edwin Brown (OWNER) |
| Authorized Official Contact | 4052470285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4334 Nw Expressway Ste 187 Oklahoma City OK 73116-1515 Ph: (405) 247-0285 | 2214 E Fairview Ave Johnson City TN 37601-2860 Ph: (423) 928-6464 |
| NPI Number | 1831774637 |
|---|---|
| Provider Enumeration Date | 03/12/2021 |
| Last Update Date | 06/10/2024 |
| Certification Date | 06/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831774637 | NPI | - | NPPES |
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