Old Towne Medical LLC
NPI #1013312172 in Olive Branch, Mississippi
Provider Information
- NPI Number
- 1013312172
- Entity Type
- Organization
- Organization Name
- Old Towne Medical LLC
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Oct 30, 2014
- Last Updated
- Jul 30, 2019
Practice Location
- Address
- 9066 HIGHLAND ST
- City
- Olive Branch
- State
- Mississippi
- ZIP Code
- 38654-2307
- Phone
- (662) 890-7717
Authorized Official
- Name
- SUSAN C BRAME, CFNP
- Title
- OWNER
- Phone
- (901) 489-6595
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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