Organization
CLINICA HISPANA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY BRADLEY (PRACTICE MANAGER)
(615) 281-0553
Entity
Organization
Contact information
Practice address
301 WOLVERINE TRL STE 202, SMYRNA, TN 37167-5656
(573) 880-0593
Mailing address
301 WOLVERINE TRL STE 202, SMYRNA, TN 37167-5656
(573) 880-0593
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588858567
NPI
TN
Enumeration date
09/29/2021
Last updated
09/29/2021
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