| Lp -jasper | |
|
5114 Us Highway 190 E Jasper TX 75951-6710 | |
| (615) 468-3188 | |
| Not Available |
| Full Name | Lp -jasper |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 5114 Us Highway 190 E, Jasper, Texas |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lp -jasper 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | Lp -jasper 5114 Us Highway 190 E Jasper TX 75951-6710 Ph: (615) 468-3188 |
| NPI Number | 1306511803 |
|---|---|
| Provider Enumeration Date | 08/16/2021 |
| Last Update Date | 08/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306511803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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