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Organization
PREVENTAGENIX LLC
Active
Organization
PREVENTAGENIX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W YOUNG (FNP/CO-OWNER)
(731) 300-0044
Entity
Organization
Contact information
Practice address
162 MURRAY GUARD DR, SUITE B, JACKSON, TN 38305-3609
(731) 300-0044
Mailing address
PO BOX 10355, JACKSON, TN 38308-0105
(731) 300-0044
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7239
TN
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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