| Leitherland Family Care Clinic, Pllc | |
|
1123 N Main St Dyer TN 38330-1019 | |
| (731) 692-2853 | |
| (731) 692-2367 |
| Full Name | Leitherland Family Care Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1123 N Main St, Dyer, Tennessee |
| Authorized Official Name and Position | Edna R Leitherland (OWNER) |
| Authorized Official Contact | 7316922853 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leitherland Family Care Clinic, Pllc 1123 N Main St Dyer TN 38330-1019 Ph: (731) 692-2853 | Leitherland Family Care Clinic, Pllc 1123 N Main St Dyer TN 38330-1019 Ph: (731) 692-2853 |
| NPI Number | 1376712448 |
|---|---|
| Provider Enumeration Date | 02/22/2008 |
| Last Update Date | 03/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376712448 | NPI | - | NPPES |
| S66580 | Other | TN | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | APN5603 (Tennessee) | Primary |
| 261QP2300X | Clinic/center - Primary Care | RN53289 (Tennessee) | Secondary |
Priority Health, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 486 Bells Chapel Rd, Dyer, TN 38330 Phone: 901-355-3319 |