Organization
WATAUGA LAKE FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY R. MILLER (BUSINESS MANAGER)
(336) 982-2158
Entity
Organization
Contact information
Practice address
140 MCQUEEN ST., BUTLER, TN 37640
(423) 768-0195
Mailing address
138 N FORK NEW RIVER RD, LANSING, NC 28643-9130
(336) 982-2158
(336) 982-3373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000041068
TN
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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