Organization
THE GROVE PRIMARY CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY WYSOR (OWNER)
(731) 983-0499
Entity
Organization
Contact information
Practice address
541 W PARK PL, SUITE C, HENDERSON, TN 38340-2027
(731) 983-0499
(731) 983-0573
Mailing address
541 W PARK PL, SUITE C, HENDERSON, TN 38340-2027
(731) 983-0499
(731) 983-0573
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/06/2008
Last updated
09/10/2019
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