Broken Arrow
NPI #1720841042 in Jefferson City, Tennessee
Provider Information
- NPI Number
- 1720841042
- Entity Type
- Organization
- Organization Name
- Broken Arrow
- Primary Specialty
- Family Medicine - Addiction Medicine
- Enumeration Date
- Jan 31, 2024
- Last Updated
- Jan 31, 2024
Practice Location
- Address
- 1009 E HIGHWAY 11 E
- City
- Jefferson City
- State
- Tennessee
- ZIP Code
- 37760-4910
- Phone
- (865) 935-0411
Authorized Official
- Name
- CRISSY SHANK
- Title
- MANAGER
- Phone
- (931) 761-5732
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Addiction Medicine — Addiction Medicine |
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