Organization
EAST TENNESSEE STATE UNIVERSITY
Active
Other names
Johnson City Downtown Clinic Day Center
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY J. KING (ACTING CHIEF FINANCIAL OFFICER)
(423) 439-4414
Entity
Organization
Contact information
Practice address
202 W FAIRVIEW AVE, JOHNSON CITY, TN 37604-5611
(423) 434-0894
(423) 434-0666
Mailing address
365 STOUT DRIVE BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4515
(423) 439-5780
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/02/2008
Last updated
07/21/2022
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