Organization
THE GROVE PRIMARY CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLAM J WYSOR (PRESIDENT)
(731) 983-0499
Entity
Organization
Contact information
Practice address
9458 HIGHWAY 100, SCOTTS HILL, TN 38374
(731) 549-3010
(731) 549-3013
Mailing address
9458 HIGHWAY 100, SCOTTS HILL, TN 38374
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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