Organization
MICROBAC HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RILEY MCDONALD (MANAGING DIRECTOR)
(855) 878-6125
Entity
Organization
Contact information
Practice address
2109 W MARKET ST, SUITE 151, JOHNSON CITY, TN 37604-6024
(855) 878-6125
(423) 979-8004
Mailing address
2109 W MARKET ST, SUITE 151, JOHNSON CITY, TN 37604-6024
(855) 878-6125
(423) 979-8004
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
44D2040965
TN
Other
Enumeration date
06/01/2012
Last updated
06/20/2012
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