Organization
AMG-HILLSIDE, LLC
Active
Other names
Ardmore Behavioral Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CLARK (VICE PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
1265 E COLLEGE ST, PULASKI, TN 38478-4541
(931) 363-7531
Mailing address
PO BOX 631, PULASKI, TN 38478-0631
(931) 363-7531
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
MD0000047963
TN
Other
Enumeration date
01/05/2012
Last updated
04/30/2012
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