Main Street Medical, Pllc
NPI #1417230129 in Ooltewah, Tennessee
Provider Information
- NPI Number
- 1417230129
- Entity Type
- Organization
- Organization Name
- Main Street Medical, Pllc
- Primary Specialty
- Specialist
- Enumeration Date
- Sep 20, 2011
- Last Updated
- Feb 9, 2020
Practice Location
Authorized Official
- Name
- PAUL A MIRANDA
- Title
- AUTHORIZED USER
- Phone
- (423) 521-5404
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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