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Organization

LISE LLC

Active
Other names
lise
Organization subpart
No

Provider details

NPI number
Authorized official
SEKOU MOLETTE (PRESIDENT)
(615) 260-8829
Entity
Organization

Contact information

Practice address
370 DOOLITTLE RD, WOODBURY, TN 37190-1129
(877) 743-2646
Mailing address
130 CINEMA DR APT 2112, HENDERSONVILLE, TN 37075-6397
(615) 260-8829

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Enumeration date
06/01/2022
Last updated
06/05/2022
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