Organization
IMPERIAL HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE R BUCKLES FNP (VICE PRESIDENT)
(423) 930-5168
Entity
Organization
Contact information
Practice address
1604 LAMONS LN STE 230, JOHNSON CITY, TN 37604-8224
(423) 930-5168
(423) 328-0193
Mailing address
1604 LAMONS LN STE 230, JOHNSON CITY, TN 37604-8224
(423) 930-5168
(423) 328-0193
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD0000038183
TN
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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