Healthcare Provider Details

I. General information

NPI: 1396282869
Provider Name (Legal Business Name): TERRA NOVA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 N MAIN ST SUITE B
SHELBYVILLE TN
37160-2391
US

IV. Provider business mailing address

1612 N MAIN ST SUITE B
SHELBYVILLE TN
37160-2391
US

V. Phone/Fax

Practice location:
  • Phone: 931-685-2022
  • Fax:
Mailing address:
  • Phone: 931-685-2022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROD PARSONS
Title or Position: CO-OWNER
Credential:
Phone: 931-685-2022