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General NPI Number Information
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NPI Number | 1598940793
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Entity Type | Organization
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Legal Business Name | MEDICAL EDUCATION ASSISTANCE CORPORATION
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 02/15/2019
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Provider Practice Location Address
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Address Line | ETSU MINI-DOME, JOHN ROBERT BELL DRIVE
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City | JOHNSON CITY
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State | TN
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Zip | 37614-1700
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Country | US
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Telephone | 423-439-4044
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2204
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City | JOHNSON CITY
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State | TN
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Zip | 37605-2204
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Country | US
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Telephone | 423-433-6050
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Fax | 423-433-6060
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | RUSSELL E LEWIS
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Credential |
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Telephone | 423-433-6050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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