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Organization

MIRA HEALTHCARE OF TENNESSEE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PHILIP W EICHENHOLZ MD (PRESIDENT)
(877) 882-9099
Entity
Organization

Contact information

Practice address
111 HIGHWAY 70 E, DICKSON, TN 37055-2080
(615) 446-0446
Mailing address
2000 E. LAMAR BLVD., SUITE 450, ARLINGTON, TX 76006
(877) 882-9099

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Enumeration date
02/11/2010
Last updated
04/13/2010
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