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General NPI Number Information
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NPI Number | 1215596549
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Entity Type | Organization
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Legal Business Name | ALTHY LIVING PLUS LLC
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 335 POPLAR VIEW LN E # 1
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City | COLLIERVILLE
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State | TN
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Zip | 38017-3192
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Country | US
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Telephone | 901-861-4705
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Fax | 901-853-3174
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Provider Business Mailing Address
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Address Line | 335 POPLAR VIEW LN E # 1
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City | COLLIERVILLE
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State | TN
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Zip | 38017-3192
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Country | US
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Telephone | 901-861-4705
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Fax | 901-853-3174
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. LAURIE ANN BARTON
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Credential | FNP
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Telephone | 901-861-4705
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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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