Organization
EAST TENNESSEE STATE UNIVERSITY
Active
Other names
Mountain City Extended Hours Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY J KING (ACTING CHIEF FINANCIAL OFFICER)
(423) 439-4414
Entity
Organization
Contact information
Practice address
1901 S SHADY STREET, MOUNTAIN CITY, TN 37683-2601
(423) 727-1150
(423) 727-1152
Mailing address
PO BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4515
(423) 439-5780
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/16/2006
Last updated
09/22/2017
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