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Organization
STATE OF TENNESSEE
Active
Organization
STATE OF TENNESSEE
Active
Other names
Montgomery County WIC Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE HALEY (REGIONAL DIRECTOR)
(615) 650-7000
Entity
Organization
Contact information
Practice address
300 PAGEANT LN, CLARKSVILLE, TN 37040-3854
(931) 551-8777
(931) 503-0694
Mailing address
300 PAGEANT LN, CLARKSVILLE, TN 37040-3854
(931) 551-8777
(931) 503-0694
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
TN
Other
Enumeration date
08/24/2010
Last updated
08/28/2012
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