Organization
NORTHWEST TENNESSEE DEVELOPMENT DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN A BUCY (EXECUTIVE DIRECTOR)
(731) 587-4213
Entity
Organization
Contact information
Practice address
124 WELDON DR, MARTIN, TN 38237-1308
(731) 587-4213
Mailing address
124 WELDON DR, P. O. BOX 963, MARTIN, TN 38237-1308
(731) 587-4213
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445784
—
TN
Enumeration date
07/30/2007
Last updated
10/31/2007
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