MEDICARE: NEUROLOGY AND NEUROMUSCULAR CENTER PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	41086	TN

General Provider Information

NPI Number	:	1821163056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY AND NEUROMUSCULAR CENTER PLC

Provider Business Mailing Address
First Line	:	324 FRANKLIN ST
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37040-3422
Country	:	US
Telephone Number	:	931-552-7474
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 DUNBAR CAVE RD STE B
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37043-8844
Country	:	US
Telephone Number	:	931-552-7474
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JACQUELINE R. ANSELL
Credential	:	M.D.
Telephone Number	:	931-552-7474

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	08/22/2020

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