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Organization
JACKSON WEIGHT MANAGEMENT, INC.
Active
Organization
JACKSON WEIGHT MANAGEMENT, INC.
Active
Other names
Achieve Medical Weight Loss
Organization subpart
No
Provider details
NPI number
Authorized official
IRA KEITH ELLIS MD (MEDICAL DIRECTOR)
(731) 610-6988
Entity
Organization
Contact information
Practice address
289 VANN DR STE A&B, JACKSON, TN 38305-6050
(731) 410-6786
Mailing address
378 CARRIAGE HOUSE DR STE E, JACKSON, TN 38305-2254
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
—
NULL
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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