| The Grove Primary Care Clinic Llc | |
|
541 W Park Pl Suite C Henderson TN 38340-2027 | |
| (731) 983-0499 | |
| (731) 983-0573 |
| Full Name | The Grove Primary Care Clinic Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 541 W Park Pl, Henderson, Tennessee |
| Authorized Official Name and Position | Jody Wysor (OWNER) |
| Authorized Official Contact | 7319830499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Grove Primary Care Clinic Llc 541 W Park Pl Suite C Henderson TN 38340-2027 Ph: (731) 983-0499 | The Grove Primary Care Clinic Llc 541 W Park Pl Suite C Henderson TN 38340-2027 Ph: (731) 983-0499 |
| NPI Number | 1639345952 |
|---|---|
| Provider Enumeration Date | 05/06/2008 |
| Last Update Date | 09/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639345952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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