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General NPI Number Information
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NPI Number | 1770397127
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Entity Type | Organization
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Legal Business Name | FAST PACE MEDICAL CLINIC PLLC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 324 MICAH WAY
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City | SCOTTSBORO
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State | AL
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Zip | 35769
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Country | US
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Telephone | 931-253-1110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 681029
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City | FRANKLIN
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State | TN
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Zip | 37068-1029
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Country | US
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Telephone | 931-253-1110
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Fax | 931-722-9919
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Authorized Official
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Title or Position | GROUP ENROLLMENT SUPERVISOR
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Name | KIMBERLY M FRAZIER
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Credential |
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Telephone | 803-804-2043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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