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Organization

FAST PACE MEDICAL CLINIC PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT BENSON (COO)
(931) 253-1110
Entity
Organization

Contact information

Practice address
817 W MAIN ST, LIVINGSTON, TN 38570-1721
(931) 219-2091
(931) 219-2182
Mailing address
PO BOX 306244, NASHVILLE, TN 37230-6244

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1515574
TN
Enumeration date
11/02/2021
Last updated
11/02/2021
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