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Organization
COVENANT PEDIATRICS, PLLC
Active
Organization
COVENANT PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMER BREEDEN (BUSINESS MANAGER)
(423) 744-8755
Entity
Organization
Contact information
Practice address
421 OLD RICEVILLE RD STE 2, ATHENS, TN 37303-3074
(423) 744-8755
(423) 744-8568
Mailing address
421 OLD RICEVILLE RD STE 2, ATHENS, TN 37303-3074
(423) 744-8755
(423) 744-8568
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
MD19704
TN
Other
Enumeration date
03/19/2011
Last updated
05/23/2022
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