Organization
ELK VALLEY MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARISSA LEE KRISHNAN (OWNER / PRACTICE MANAGER)
(931) 619-3243
Entity
Organization
Contact information
Practice address
305 COLLEGE ST W, FAYETTEVILLE, TN 37334-2911
(931) 619-3243
(888) 696-1054
Mailing address
305 COLLEGE ST W, FAYETTEVILLE, TN 37334-2911
(931) 297-4525
(888) 696-1054
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/23/2017
Last updated
01/23/2018
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