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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