MEDICARE: BENJAMIN HUNTER GARLAND SOCIAL WORKER

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1891069316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN HUNTER GARLAND SOCIAL WORKER

Provider Business Mailing Address
First Line	:	99 VETERANS WAY
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604
Country	:	US
Telephone Number	:	423-926-1171
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 VETERANS WAY
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-5470
Country	:	US
Telephone Number	:	423-926-1171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2012
Last Update Date	:	03/01/2012

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