Organization
DRAGONFLY TELEHEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY MODENA TATUM FNP-C (CEO)
(931) 628-9210
Entity
Organization
Contact information
Practice address
160 SEPTEMBER DR, STREETMAN, TX 75859-3261
(931) 628-9210
Mailing address
160 SEPTEMBER DR, STREETMAN, TX 75859-3261
(931) 628-9210
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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