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General NPI Number Information
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NPI Number | 1891861274
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Entity Type | Organization
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Legal Business Name | GRABENSTEIN FAMILY PRACTICE
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 1822 MEMORIAL DRIVE
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City | CLARKSVILLE
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State | TN
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Zip | 37043
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Country | US
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Telephone | 931-552-8010
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Fax | 931-551-3118
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Provider Business Mailing Address
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Address Line | 1822 MEMORIAL DRIVE
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City | CLARKSVILLE
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State | TN
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Zip | 37043
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Country | US
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Telephone | 931-552-8010
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Fax | 931-551-3118
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM GRABENSTEIN
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Credential | MD
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Telephone | 931-552-8010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | TN
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