Northwest Tennessee Development District
Point of Service in Martin, TN. Organization (NPI-2).
NPI number1114117751
StatusActive
Last updated in NPPESOct 31, 2007
Details
- NPI
- 1114117751
- Entity type
- Organization (NPI-2)
- Legal business name
- Northwest Tennessee Development District
- Organization subpart
- No
- Enumeration date
- Jul 30, 2007
- Last updated
- Oct 31, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305S00000X | Point of Service | – | – | Yes |
Practice location
124 Weldon DrMartin, TN 38237-1308
Phone 731-587-4213
Mailing address
124 Weldon DrP. O. Box 963
Martin, TN 38237-1308
Phone 731-587-4213
Authorized official
John A Bucy
Executive Director
7315874213
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