| Coosa Valley Sports Medicine And Primary Care Llc | |
|
209 W Spring St Suite 305 Sylacauga AL 35150-2973 | |
| (256) 245-3201 | |
| (256) 245-4112 |
| Full Name | Coosa Valley Sports Medicine And Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 209 W Spring St, Sylacauga, Alabama |
| Authorized Official Name and Position | Kennieth C Mccollough (OWNER) |
| Authorized Official Contact | 2562453201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coosa Valley Sports Medicine And Primary Care Llc 209 W Spring St Suite 305 Sylacauga AL 35150-2973 Ph: (256) 245-3201 | Coosa Valley Sports Medicine And Primary Care Llc 209 W Spring St Suite 305 Sylacauga AL 35150-2973 Ph: (256) 245-3201 |
| NPI Number | 1871924357 |
|---|---|
| Provider Enumeration Date | 12/09/2013 |
| Last Update Date | 12/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871924357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD.29754 (Alabama) | Primary |
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