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Organization
MONTCLAIR HEALTH AND WELLNESS LLC
Active
Organization
MONTCLAIR HEALTH AND WELLNESS LLC
Active
Other names
Specialty Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA D WHITE (OFFICE MANAGER)
(931) 212-1117
Entity
Organization
Contact information
Practice address
710 CORNERSVILLE RD, LEWISBURG, TN 37091
(931) 994-5717
(931) 246-4233
Mailing address
710 CORNERSVILLE RD, LEWISBURG, TN 37091
(931) 422-2192
(931) 246-4233
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000006822
TN
363LF0000X
Family Nurse Practitioner
APN0000012854
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q005482
—
TN
Enumeration date
03/24/2011
Last updated
08/19/2019
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