Organization
PETTY ADULT AND GERIATRIC CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER ANN PETTY APRN (ORGANIZER)
(615) 443-2273
Entity
Organization
Contact information
Practice address
1123 N CASTLE HEIGHTS AVE, SUITE H, LEBANON, TN 37087-5724
(615) 443-2273
(615) 449-3111
Mailing address
1123 N CASTLE HEIGHTS AVE, SUITE H, LEBANON, TN 37087-5724
(615) 443-2273
(615) 449-3111
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
11466
TN
Other
Enumeration date
10/25/2007
Last updated
10/07/2008
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