Elk Valley Medical Clinic, LLC
NPI #1205356813 in Fayetteville, Tennessee
Provider Information
- NPI Number
- 1205356813
- Entity Type
- Organization
- Organization Name
- Elk Valley Medical Clinic, LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Jun 23, 2017
- Last Updated
- Jan 23, 2018
Practice Location
- Address
- 305 COLLEGE ST W
- City
- Fayetteville
- State
- Tennessee
- ZIP Code
- 37334-2911
- Phone
- (931) 619-3243
Authorized Official
- Name
- KARISSA LEE KRISHNAN
- Title
- OWNER / PRACTICE MANAGER
- Phone
- (931) 619-3243
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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