Organization
CROSSROADS CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN VERGOT MD (OWNER)
(423) 902-0681
Entity
Organization
Contact information
Practice address
1667 OOLTEWAH RINGGOLD RD, SUITE 111, OOLTEWAH, TN 37363-9830
(423) 825-4881
(423) 825-4882
Mailing address
1667 OOLTEWAH RINGGOLD RD, SUITE 111, OOLTEWAH, TN 37363-9830
(423) 825-4881
(423) 825-4882
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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