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General NPI Number Information
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NPI Number | 1053628867
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Entity Type | Organization
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Legal Business Name | FAST PACE MEDICAL CLINIC PLLC
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 1415 HILLSBORO BLVD
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City | MANCHESTER
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State | TN
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Zip | 37355-2690
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Country | US
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Telephone | 931-253-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 6550 CAROTHERS PKWY STE 225
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City | FRANKLIN
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State | TN
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Zip | 37067-6662
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Country | US
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Telephone | 931-250-1110
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Fax | 931-722-9919
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Authorized Official
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Title or Position | DIRECTOR
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Name | MELISSA HARLAN
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Credential |
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Telephone | 615-948-9639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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