Organization · Type 2 NPI
State of Tennessee
Public Health or Welfare Agency · Portland, TN
NPI number
1003090036
Active
Practice location
214 West Longview Drive
Portland, TN 37148
Fax (615) 325-5549
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Public Health or Welfare Agency Primary | 251K00000X | None listed |
Public Health or Welfare Agency: Definition to come...
About NPI 1003090036
State of Tennessee's National Provider Identifier is 1003090036, issued on Dec 27, 2007. The primary taxonomy on file is Public Health or Welfare Agency (251K00000X), and the practice location is in Portland, TN. The record was last updated on Aug 28, 2012.