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George J Bacon

Case Manager/Care Coordinator in Covington, TN. Individual provider (NPI-1).

NPI number1255600524
StatusActive
Last updated in NPPESDec 15, 2011

Details

NPI
1255600524
Entity type
Individual (NPI-1)
Name
George J Bacon
Sex
Male
Sole proprietor
No
Enumeration date
Dec 15, 2011
Last updated
Dec 15, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator––Yes

Practice location

1997 Highway 51 S
Covington, TN 38019-3630

Phone 901-476-8967

Mailing address

1997 Highway 51 S
Covington, TN 38019-3630

Phone 901-476-8967

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