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8950 Us Highway 64 Suite 109 Lakeland TN 38002-4566 | |
(901) 213-0100 | |
(901) 213-0101 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 8950 Us Highway 64, Lakeland, Tennessee |
Authorized Official Name and Position | Catherine Hollahan (NURSE PRACTITIONER) |
Authorized Official Contact | 9012130100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8950 Us Highway 64 Suite 109 Lakeland TN 38002-4566 Ph: (901) 213-0100 | 8950 Us Highway 64 Suite 109 Lakeland TN 38002-4566 Ph: (901) 213-0100 |
NPI Number | 1275962763 |
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Provider Enumeration Date | 11/05/2013 |
Last Update Date | 11/07/2013 |
Identifier | Type | State | Issuer |
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1275962763 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |