Adult & Pediatric Dermatology Skin Solutions PLLC
Physician Assistant, Medical in Tullahoma, TN. Organization (NPI-2).
NPI number1295324366
StatusActive
Last updated in NPPESJun 1, 2022
Details
- NPI
- 1295324366
- Entity type
- Organization (NPI-2)
- Legal business name
- Adult & Pediatric Dermatology Skin Solutions PLLC
- Organization subpart
- No
- Enumeration date
- Jan 13, 2021
- Certification date
- Jun 1, 2022
- Last updated
- Jun 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
Practice location
151 Ledford Mill RdTullahoma, TN 37388-2278
Phone 931-800-6400 · Fax 931-800-6401
Mailing address
Po Box 802Tullahoma, TN 37388-0802
Phone 931-800-6400 · Fax 931-800-6401
Authorized official
Lorie M Burtts
Office Manager
9318006400
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