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Organization
WILLOW MEDICAL, LLC
Active
Organization
WILLOW MEDICAL, LLC
Active
Other names
Blessed Medical, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE PROPST (OWNER)
(931) 728-3097
Entity
Organization
Contact information
Practice address
193 RELCO DR, MANCHESTER, TN 37355-7386
(931) 728-3097
Mailing address
193 RELCO DR, MANCHESTER, TN 37355-7386
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000010747
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1509931
—
TN
Enumeration date
11/05/2010
Last updated
05/02/2012
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