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Organization

HEALTHY LIFE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRISELLE VIRGINIA FIGUEREDO CARDENAS MD (OWNER)
(901) 385-6988
Entity
Organization

Contact information

Practice address
3068 COVINGTON PIKE, STE 3, MEMPHIS, TN 38128-5001
(901) 385-6988
Mailing address
3068 COVINGTON PIKE, STE 3, MEMPHIS, TN 38128-5001
(901) 385-6988

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31712
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31712
LICENSE
TN
Enumeration date
05/06/2008
Last updated
01/29/2011
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