| Ten Broeck Tennessee Physicians Group Inc | |
|
911 N Shelby St Salem IN 47167-2304 | |
| (812) 883-8583 | |
| (812) 883-8595 |
| Full Name | Ten Broeck Tennessee Physicians Group Inc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 911 N Shelby St, Salem, Indiana |
| Authorized Official Name and Position | Karissa Hutson (BUSINESS OFFICE) |
| Authorized Official Contact | 9313194231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ten Broeck Tennessee Physicians Group Inc 911 N Shelby St Salem IN 47167-2304 Ph: (812) 883-8583 | Ten Broeck Tennessee Physicians Group Inc 911 N Shelby St Salem IN 47167-2304 Ph: (812) 883-8583 |
| NPI Number | 1164008553 |
|---|---|
| Provider Enumeration Date | 03/24/2021 |
| Last Update Date | 03/24/2021 |
| Certification Date | 03/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164008553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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