Organization
THE MICHAL CHILD DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARY L MICHAL MD (DIRECTOR)
(423) 928-9007
Entity
Organization
Contact information
Practice address
302 WESLEY ST STE 10, JOHNSON CITY, TN 37601-1769
(423) 928-9007
(423) 928-9249
Mailing address
302 WESLEY ST STE 10, JOHNSON CITY, TN 37601-1769
(423) 928-9007
(423) 928-9249
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD3984
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275534810
NPI
TN
05
—
6906086
—
NC
Enumeration date
03/12/2008
Last updated
03/12/2008
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