Organization · NPI-2

Alliance Medical Clinic PC

Family Medicine · Jackson, TN

NPI number1629494786
StatusActive
Last updated in NPPESJul 18, 2014

Details

NPI
1629494786
Entity type
Organization (NPI-2)
Legal business name
Alliance Medical Clinic PC
Organization subpart
No
Enumeration date
Mar 13, 2014
Last updated
Jul 18, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

21 Meridian Springs Dr
Jackson, TN 38301-5900

Phone 731-421-8088 · Fax 731-421-8091

Mailing address

21 Meridian Springs Dr
Jackson, TN 38301-5900

Phone 731-421-8088 · Fax 731-421-8091

Authorized official

Marianna Forsythe
Director
7315120104

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