King'S Way Family Medicine, LLC
Clinic/Center, Primary Care in Greeneville, TN. Organization (NPI-2).
NPI number1083178974
StatusActive
Last updated in NPPESJan 30, 2019
Details
- NPI
- 1083178974
- Entity type
- Organization (NPI-2)
- Legal business name
- King'S Way Family Medicine, LLC
- Organization subpart
- No
- Enumeration date
- Jan 25, 2019
- Last updated
- Jan 30, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Practice location
318 Tusculum BlvdGreeneville, TN 37745-3926
Phone 423-639-7700 · Fax 423-639-7700
Mailing address
318 Tusculum BlvdGreeneville, TN 37745-3926
Phone 386-837-2969
Authorized official
Heather Olson
Owner/Provider
3868013083
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