Organization
MOBILE OCC MED AND WELLNESS, PLLC
Active
Organization
MOBILE OCC MED AND WELLNESS, PLLC
Active
Other names
Emmaus Medical and Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES L BACKUS III DO (MEDICAL DIRECTOR)
(423) 676-8400
Entity
Organization
Contact information
Practice address
273 HIGHWAY 11 E, BULLS GAP, TN 37711-3433
(423) 676-8400
(423) 393-4344
Mailing address
273 HIGHWAY 11 E, BULLS GAP, TN 37711-3433
(423) 676-8400
(423) 393-4377
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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