Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA TARTE (ENROLLMENT TEAM LEAD)
(423) 302-6567
Entity
Organization
Contact information
Practice address
410 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6971
(423) 431-2477
(423) 431-2478
Mailing address
509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
02/02/2022
Last updated
05/24/2022
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