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Organization

MOUNTAIN STATES HEALTH ALLIANCE

Active
Other names
Johnson City Medical Center, Regional Cancer Center
Organization subpart
No

Provider details

NPI number
Authorized official
GRACIELA PEREIRA (AVP)
(423) 431-7060
Entity
Organization

Contact information

Practice address
1 PROFESSIONAL PARK DR, SUITE 21 ROOM C-17, JOHNSON CITY, TN 37604-6587
(423) 232-6900
(423) 232-6903
Mailing address
1 PROFESSIONAL PARK DR, SUITE 21 ROOM C-17, JOHNSON CITY, TN 37604-6587
(423) 232-6900
(423) 232-6903

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
03/04/2011
Last updated
03/04/2011
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