Amg-Southern Tennessee LLC

NPI #1073612578 in Tullahoma, Tennessee

Provider Information

NPI Number: 1073612578
Entity Type: Organization
Organization Name: Amg-Southern Tennessee LLC
Subpart: Yes (part of a larger organization)
Parent Organization: AMG-SOUTHERN TENNESSEE LLC
Primary Specialty: General Practice
Enumeration Date: Sep 21, 2006
Last Updated: Jun 17, 2008

Practice Location

Address: 10054 OLD TULLAHOMA RD
City: Tullahoma
State: Tennessee
ZIP Code: 37388-6122
Phone: (931) 455-6688

Authorized Official

Name: WILLIAM GRACEY
Title: COO
Phone: (615) 372-8500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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