Organization
FAST PACE MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BENSON (COO)
(931) 253-1110
Entity
Organization
Contact information
Practice address
510 N MAIN ST, ROCKY TOP, TN 37769-2818
(865) 208-9582
(865) 205-9583
Mailing address
PO BOX 306244, NASHVILLE, TN 37230-6244
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515574
—
TN
Enumeration date
11/17/2021
Last updated
11/17/2021
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