3 Ple O Llpc
Family Medicine in Red Boiling Springs, TN. Organization (NPI-2).
NPI number1508488800
StatusActive
Last updated in NPPESAug 7, 2020
Details
- NPI
- 1508488800
- Entity type
- Organization (NPI-2)
- Legal business name
- 3 Ple O Llpc
- Organization subpart
- No
- Enumeration date
- May 11, 2020
- Certification date
- Aug 7, 2020
- Last updated
- Aug 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Rbs Healhcare (Doing Business As)
Practice location
165 Dale StRed Boiling Springs, TN 37150-2102
Phone 615-699-3169
Mailing address
209 College StLafayette, TN 37083-1701
Phone 615-406-8891 · Fax 615-666-3488
Authorized official
Olufemi Odunusi
Ceo
6154068891
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