Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Other names
BUC SPORTS/UNIVERSITY PHYSICIANS PRACTICE GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
ETSU MINI-DOME, JOHN ROBERT BELL DRIVE, JOHNSON CITY, TN 37614-1700
(423) 439-4044
Mailing address
PO BOX 2204, JOHNSON CITY, TN 37605-2204
(423) 433-6050
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2008
Last updated
02/15/2019
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