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Organization

CLINIC FOR PRODUCTIVE LIVING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD C ROLAND (OWNER)
(865) 394-9337
Entity
Organization

Contact information

Practice address
9217 PARK WEST BLVD, SUITE E1, KNOXVILLE, TN 37923-4404
(865) 394-9337
(865) 394-9336
Mailing address
9217 PARK WEST BLVD, SUITE E1, KNOXVILLE, TN 37923-4404
(865) 394-9337
(865) 394-9336

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APN11916
TN

Other

Enumeration date
10/15/2012
Last updated
10/15/2012
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