| Guic Llc | |
|
1400 Willow Drive Manchester TN 37355 | |
| (931) 728-7677 | |
| (931) 728-7066 |
| Full Name | Guic Llc |
|---|---|
| Speciality | General Practice |
| Location | 1400 Willow Drive, Manchester, Tennessee |
| Authorized Official Name and Position | S M Shelley (CEO OF GUIC LLC) |
| Authorized Official Contact | 9317287677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Guic Llc Po Box 1802 Manchester TN 37349-4802 Ph: (931) 728-7677 | Guic Llc 1400 Willow Drive Manchester TN 37355 Ph: (931) 728-7677 |
| NPI Number | 1417975863 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 11/06/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417975863 | NPI | - | NPPES |
| 3732548 | Medicaid | TN | |
| 4115812 | Other | TN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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