Organization
PEOPLE2PLACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILEY MCCLOUD (PRESIDENT OWNER)
(865) 397-1250
Entity
Organization
Contact information
Practice address
444 E BROADWAY BLVD, JEFFERSON CITY, TN 37760-2903
(865) 475-3433
Mailing address
444 E BROADWAY BLVD, JEFFERSON CITY, TN 37760-2903
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
0514679
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T000153
—
TN
Enumeration date
04/06/2007
Last updated
01/11/2012
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