Organization
PREMIER AGE MANAGEMENT AND MEDICAL WEIGHT LOSS CENTER, LLC
Active
Organization
PREMIER AGE MANAGEMENT AND MEDICAL WEIGHT LOSS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM RYAN WALKER ESQ. (ADMINISTRATIVE DIRECTOR)
(615) 649-9600
Entity
Organization
Contact information
Practice address
229 WARD CIR, A-23, BRENTWOOD, TN 37027-7518
(615) 649-9600
(615) 649-9601
Mailing address
229 WARD CIR, A-23, BRENTWOOD, TN 37027-7518
(615) 649-9600
(615) 649-9601
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
—
—
133N00000X
Nutritionist
—
—
207Q00000X
Family Medicine Physician
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2083S0010X
Sports Medicine (Preventive Medicine) Physician
—
—
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
TN
363L00000X
Nurse Practitioner
—
TN
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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