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Organization
PRIMECARE CLINIC, PLLC
Active
Organization
PRIMECARE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA NKOMAZANA (PRACTICE MANAGER)
(731) 376-1851
Entity
Organization
Contact information
Practice address
622 NUCKOLLS RD, BOLIVAR, TN 38008-1532
(731) 658-2120
Mailing address
PO BOX 479, BOLIVAR, TN 38008-0479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25889
TN
207R00000X
Internal Medicine Physician
38934
TN
Other
Enumeration date
04/13/2007
Last updated
04/07/2010
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