Healthcare Provider Details

I. General information

NPI: 1053040147
Provider Name (Legal Business Name): NOTTA GROUP OF COMPANIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/06/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 NORTHGATE MALL DRIVE, SUITE 104
CHATTANOOGA TN
37415
US

IV. Provider business mailing address

7720 LEGENDS WAY
CHATTANOOGA TN
37421-7101
US

V. Phone/Fax

Practice location:
  • Phone: 561-275-2020
  • Fax: 561-828-8367
Mailing address:
  • Phone: 561-275-2020
  • Fax: 561-828-8367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DANIEL GARZA
Title or Position: MANAGED CARE DIRECTOR
Credential:
Phone: 561-720-6423