Organization
WILLOW MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY SHELLEY (OFFICE MANAGER/ASSIST. BUSINESS ADM)
(931) 570-4755
Entity
Organization
Contact information
Practice address
1400 WILLOW DR, MANCHESTER, TN 37355-2438
(931) 728-7677
(931) 728-7066
Mailing address
PO BOX 1223, MANCHESTER, TN 37349-1223
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/29/2008
Last updated
07/29/2008
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