Organization
MENDING FENCES
Active
Other names
Mending Fences, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TILMAN MEARS (INTERIM CEO)
(352) 528-2801
Entity
Organization
Contact information
Practice address
15530 W HIGHWAY 326, MORRISTON, FL 32668-7311
(352) 528-1300
(352) 528-0651
Mailing address
15530 W HIGHWAY 326, MORRISTON, FL 32668-7311
(352) 528-1300
(352) 528-0651
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
4246425857601
FL
Other
Enumeration date
10/12/2016
Last updated
05/08/2018
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