Organization
EVOLUTION MEDICAL AND AESTHETICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN ELIZABETH KELLY FNP (OWNER)
(423) 817-3542
Entity
Organization
Contact information
Practice address
3815 TN-66, SUITE 1, ROGERSVILLE, TN 37857
(423) 817-3542
(423) 717-5562
Mailing address
239 CLIFFORD PRICE LOOP, MOORESBURG, TN 37811
(423) 754-9648
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/08/2024
Last updated
01/20/2026
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