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General NPI Number Information
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NPI Number | 1891861159
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Entity Type | Organization
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Legal Business Name | THERESA BUCK'S URGENT CARE WALK IN CLINIC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 1100 SMITHVILLE HWY STE 123
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City | MC MINNVILLE
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State | TN
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Zip | 37110-1665
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Country | US
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Telephone | 931-507-9355
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Fax | 931-507-9355
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Provider Business Mailing Address
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Address Line | 1100 SMITHVILLE HWY STE 123
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City | MC MINNVILLE
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State | TN
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Zip | 37110-1665
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Country | US
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Telephone | 931-507-9355
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Fax | 931-507-9355
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Authorized Official
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Title or Position | OWNER
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Name | THERESA BUCK
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Credential |
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Telephone | 931-507-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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