Organization
STONES RIVER REGIONAL INDEPENDENT PRACTICE ASSOCIATION
Active
Organization
STONES RIVER REGIONAL INDEPENDENT PRACTICE ASSOCIATION
Active
Other names
Stones River Regional IPA
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN VANDAGRIFF (CREDENTIALING MANAGER)
(615) 869-0031
Entity
Organization
Contact information
Practice address
1620 GATEWAY BLVD STE 102, MURFREESBORO, TN 37129
(615) 869-0030
(615) 869-0040
Mailing address
1620 GATEWAY BLVD STE 102, MURFREESBORO, TN 37129
(615) 869-0030
(615) 869-0040
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
01/28/2011
Last updated
12/20/2024
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