Organization
EAST TENNESSEE MEDICAL GROUP, P.C.
Active
Organization
EAST TENNESSEE MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHAIRIYA C BRYANT ESQ (CREDENTIALING MANAGER)
(864) 343-0010
Entity
Organization
Contact information
Practice address
281 UNDERPASS DR, ONEIDA, TN 37841-5885
(423) 569-5454
(423) 569-5858
Mailing address
25 AIRPARK CT, GREENVILLE, SC 29607-6188
(864) 343-0010
(864) 312-6927
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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