MEDICARE: ALL FOR WOMEN HEALTHCARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1023521119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL FOR WOMEN HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	223 HIAWASSEE AVE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37917-4933
Country	:	US
Telephone Number	:	865-299-2432
Fax Number	:

Provider Business Practice Location Address
First Line	:	2605 E 3300 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-2728
Country	:	US
Telephone Number	:	801-746-7467
Fax Number	:	801-746-7469

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	THEO S STEPHENS
Credential	:
Telephone Number	:	865-299-2432

Provider Enumeration Date	:	11/10/2017
Last Update Date	:	11/10/2017

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