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9298 Apison Pike Ooltewah TN 37363-7267 | |
| (877) 286-9799 | |
| (263) 372-5586 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 9298 Apison Pike, Ooltewah, Tennessee |
| Authorized Official Name and Position | Janice Renner (PROVIDER) |
| Authorized Official Contact | 8772869799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
N61w23044 Harrys Way Sussex WI 53089-3995 Ph: (317) 791-6691 | 9298 Apison Pike Ooltewah TN 37363-7267 Ph: (877) 286-9799 |
| NPI Number | 1376078139 |
|---|---|
| Provider Enumeration Date | 04/28/2017 |
| Last Update Date | 04/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376078139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 202 (Tennessee) | Primary |
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