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General NPI Number Information
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NPI Number | 1497920730
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Entity Type | Organization
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Legal Business Name | BRISTOL LABORATORIES, LLC
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 337 BLUFF CITY HWY SUITE 206
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City | BRISTOL
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State | TN
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Zip | 37620-4629
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Country | US
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Telephone | 423-652-2368
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Fax |
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Provider Business Mailing Address
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Address Line | 337 BLUFF CITY HWY SUITE 206
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City | BRISTOL
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State | TN
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Zip | 37620-4629
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Country | US
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Telephone | 423-652-2368
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. BETH KRISTIN PALIN
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Credential | J.D.
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Telephone | 423-652-2368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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