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General NPI Number Information
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NPI Number | 1649851163
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Entity Type | Organization
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Legal Business Name | LEGACY URGENT CARE
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 7022 SILVER FOX ST
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City | SMYRNA
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State | TN
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Zip | 37167-1097
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Country | US
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Telephone | 931-334-3211
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Fax |
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Provider Business Mailing Address
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Address Line | 479 W SAM RIDLEY PKWY STE 105-301
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City | SMYRNA
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State | TN
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Zip | 37167-6486
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Country | US
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Telephone | 931-334-3211
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MIASCHIA BRYANNA SCOTT
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Credential | FNP-C
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Telephone | 931-334-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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