Organization
COVENANT FAMILY PRACTICE 2LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA HOLDEN ACCOUNTING (LEAD)
(404) 943-0205
Entity
Organization
Contact information
Practice address
123B CENTER POINTE DR, CLARKSVILLE, TN 37040-8424
(404) 943-0205
Mailing address
PO BOX 468329, ATLANTA, GA 31146-8329
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/24/2007
Last updated
07/24/2007
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