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Organization
MIRACLE HEALTHCARE LLC
Active
Organization
MIRACLE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOSHA MESSENGER (OWNER)
(731) 658-2885
Entity
Organization
Contact information
Practice address
649B W MCNEAL ST, BOLIVAR, TN 38008-2519
(731) 658-2885
(731) 658-2886
Mailing address
649B W MCNEAL ST, BOLIVAR, TN 38008-2519
(731) 658-2885
(731) 658-2886
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/25/2010
Last updated
03/25/2010
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