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Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
MSMG FP ST PA, BHRHC St. Paul, BHRHC ST PAUL
Organization subpart
No
Provider details
NPI number
Authorized official
JUANITA HARWOOD (DIRECTOR)
(423) 392-6565
Entity
Organization
Contact information
Practice address
16431 WISE ST, ST PAUL, VA 24283
(276) 762-2300
(276) 762-0612
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6567
(276) 762-0612
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/20/2008
Last updated
08/12/2024
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