State of Tennessee
NPI #1902827363 in Waynesboro, Tennessee
Provider Information
- NPI Number
- 1902827363
- Entity Type
- Organization
- Organization Name
- State of Tennessee
- Primary Specialty
- Public Health or Welfare
- Enumeration Date
- Jul 21, 2006
- Last Updated
- Sep 25, 2012
Practice Location
- Address
- 102 J V MANGUBAT DR
- City
- Waynesboro
- State
- Tennessee
- ZIP Code
- 38485-2439
- Phone
- (931) 722-3292
Authorized Official
- Name
- BARBARA J WHITWELL
- Title
- OFFICE SUPERVISOR
- Phone
- (931) 490-8334
Specialties & Taxonomy Codes
| Specialty |
|---|
| Public Health or Welfare |
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