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General NPI Number Information
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NPI Number | 1447732235
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Entity Type | Organization
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Legal Business Name | BACK TO NU LOW T SOLUTIONS, LLC
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 2271 HIGHWAY 11 E UNIT 1
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City | LENOIR CITY
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State | TN
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Zip | 37772
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Country | US
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Telephone | 865-816-3393
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Fax |
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Provider Business Mailing Address
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Address Line | 2271 HIGHWAY 11 E UNIT 1
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City | LENOIR CITY
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State | TN
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Zip | 37772
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Country | US
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Telephone | 865-816-3393
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Fax | 865-681-6858
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. BRENDA A BRYANT
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Credential |
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Telephone | 865-684-6812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | TN
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