Healthcare Provider Details

I. General information

NPI: 1689418998
Provider Name (Legal Business Name): FAST PACE MEDICAL CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 06/21/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 W REELFOOT AVE
UNION CITY TN
38261-5569
US

IV. Provider business mailing address

6550 CAROTHERS PKWY STE 225
FRANKLIN TN
37067-6662
US

V. Phone/Fax

Practice location:
  • Phone: 731-599-1102
  • Fax:
Mailing address:
  • Phone: 615-364-1773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA HARLAN
Title or Position: DIRECTOR
Credential:
Phone: 615-948-9639