Organization
MIND BODY BEAUTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WALLS (OWNER)
(865) 335-0331
Entity
Organization
Contact information
Practice address
950 MAIN ST STE E, WARTBURG, TN 37887-4310
(865) 410-4611
Mailing address
384 LANCER RD, HARRIMAN, TN 37748-4834
(865) 335-0331
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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