Organization
APP OF TENNESSEE ED, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GRIMES (CFO)
(615) 551-6611
Entity
Organization
Contact information
Practice address
907 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804
(865) 983-7211
Mailing address
PO BOX 31957, CLARKSVILLE, TN 37040-0033
(205) 313-5245
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/07/2014
Last updated
01/27/2023
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