| Elk Valley Medical Clinic, Llc | |
|
305 College St W Fayetteville TN 37334-2911 | |
| (931) 619-3243 | |
| (888) 696-1054 |
| Full Name | Elk Valley Medical Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 305 College St W, Fayetteville, Tennessee |
| Authorized Official Name and Position | Karissa Lee Krishnan (OWNER / PRACTICE MANAGER) |
| Authorized Official Contact | 9316193243 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elk Valley Medical Clinic, Llc 305 College St W Fayetteville TN 37334-2911 Ph: (931) 297-4525 | Elk Valley Medical Clinic, Llc 305 College St W Fayetteville TN 37334-2911 Ph: (931) 619-3243 |
| NPI Number | 1205356813 |
|---|---|
| Provider Enumeration Date | 06/23/2017 |
| Last Update Date | 01/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205356813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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