Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA CASTRO MD (MEDICAL DIRECTOR)
(423) 431-5339
Entity
Organization
Contact information
Practice address
400 N ST OF FRANKLIN RD, JOHNSON CITY, TN 37604
(423) 431-5339
Mailing address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-5339
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
21920
TN
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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