Organization
PATH BREAKERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLIE SAULS MCNABB B.S. (PRESIDENT)
(423) 329-7508
Entity
Organization
Contact information
Practice address
320 PREACHER LAWS RD, AFTON, TN 37616-6450
(423) 329-7508
Mailing address
320 PREACHER LAWS RD, AFTON, TN 37616-6450
(423) 329-7508
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/07/2010
Last updated
01/07/2010
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