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168 W University Pkwy Jackson TN 38305-1624 | |
| (731) 660-0199 | |
| (731) 227-6116 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 168 W University Pkwy, Jackson, Tennessee |
| Authorized Official Name and Position | Perry Bolton Pratt (OWNER) |
| Authorized Official Contact | 7318034652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
162 Rolling Oaks Dr Humboldt TN 38343-8585 Ph: (731) 803-4652 | 168 W University Pkwy Jackson TN 38305-1624 Ph: (731) 660-0199 |
| NPI Number | 1295363182 |
|---|---|
| Provider Enumeration Date | 03/28/2020 |
| Last Update Date | 02/05/2025 |
| Certification Date | 02/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295363182 | NPI | - | NPPES |
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