Organization
TEN BROECK TENNESSEE PHYSICIANS GROUP INC
Active
Other names
Vibrant Living: A Program For Seniors
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA F GUY (DIRECTOR, COMPLIANCE)
(931) 607-6513
Entity
Organization
Contact information
Practice address
819 N 1ST ST, DENNISON, OH 44621-1003
(740) 922-7415
(740) 922-7413
Mailing address
PO BOX 1100, WINDERMERE, FL 34786-1100
(931) 607-6513
(407) 876-9170
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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