Organization
MSP BOONE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN D TENLEY DPM (AUTHORIZED OFFICIAL)
(828) 265-3668
Entity
Organization
Contact information
Practice address
200 HOSPITAL AVE FL 3, JEFFERSON, NC 28640-9244
(828) 265-9662
(828) 252-2272
Mailing address
610 STATE FARM RD STE C, BOONE, NC 28607-4713
(828) 265-3668
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Enumeration date
11/21/2023
Last updated
11/29/2023
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