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Organization

FOUNDATION MEDICAL, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER TEAGUE GOOD (FACILITY DIRECTOR/OWNER)
(423) 202-3008
Entity
Organization

Contact information

Practice address
1730 OLD GRAY STATION RD, JOHNSON CITY, TN 37615-3869
(423) 202-3008
(423) 202-7835
Mailing address
1730 OLD GRAY STATION RD, JOHNSON CITY, TN 37615-3869
(423) 202-3008
(423) 202-7835

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
1000000022019
TN

Other

Enumeration date
04/17/2018
Last updated
07/24/2019
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