Organization
SOUTHERN CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATASHA JARNAGIN FNP-BC (OWNER)
(865) 898-8318
Entity
Organization
Contact information
Practice address
1179 HIGHWAY 11W, BEAN STATION, TN 37708-5809
(865) 898-8318
Mailing address
PO BOX 280, BEAN STATION, TN 37708-0280
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
13557
TN
Other
Enumeration date
02/11/2013
Last updated
02/11/2013
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