# URBAN RADIANCE MEDICAL SPA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Urban Radiance Medical Spa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356234272
- **Authorized official:** HEATHER A MULLINS (PRACTICE MANAGER)
- **Authorized official phone:** (423) 839-0710

## Contact information

- **Practice address:** 5675 W ANDREW JOHNSON HWY, MORRISTOWN, TN 37814-1031
- **Practice address phone:** (423) 839-0710
- **Practice address fax:** (689) 232-4757
- **Mailing address:** 5675 W ANDREW JOHNSON HWY, MORRISTOWN, TN 37814-1031
- **Mailing address phone:** (423) 839-0710
- **Mailing address fax:** (689) 232-4757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/30/2025
- **Last updated:** 05/30/2025