Organization
PRIVIA MEDICAL GROUP TENNESSEE LLC
Active
Other names
Sports Ortho Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ROLLER (ASSOCIATE DIRECTOR/ENROLLMENT)
(770) 312-5226
Entity
Organization
Contact information
Practice address
2213 MEMORIAL BLVD, SUITE D, MURFREESBORO, TN 37129
(571) 982-6636
Mailing address
950 N GLEBE RD STE 700, ARLINGTON, VA 22203-4173
(571) 982-6636
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
12/06/2021
Last updated
07/13/2022
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