Organization
MONTEREY MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL DENISE VAUGHN (VICE PRESIDENT)
(931) 260-5756
Entity
Organization
Contact information
Practice address
400 W CRAWFORD AVE, MONTEREY, TN 38574-1166
(931) 839-2224
(931) 839-2530
Mailing address
400 W CRAWFORD AVE, MONTEREY, TN 38574-1166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/12/2021
Last updated
07/08/2021
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