Organization
ADDICTION RECOVERY CENTER OF EAST TN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MACK LYNN HICKS MD (OWNER)
(423) 914-3195
Entity
Organization
Contact information
Practice address
3763 HIGHWAY 11 W, BLOUNTVILLE, TN 37617-3407
(423) 279-3860
(423) 279-3861
Mailing address
3763 HIGHWAY 11 W, BLOUNTVILLE, TN 37617-3407
(423) 279-3860
(423) 279-3861
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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