Organization
BEDROCKHC AT SPRING MEADOWS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH D NICHOLS (MANAGER)
(813) 777-4663
Entity
Organization
Contact information
Practice address
220 HIGHWAY 76, CLARKSVILLE, TN 37043-4102
(931) 552-0181
(931) 552-9683
Mailing address
220 HIGHWAY 76, CLARKSVILLE, TN 37043-4102
(931) 552-0181
(931) 552-9683
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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