Organization
EAST TENNESSEE STATE UNIVERSITY
Active
Other names
ETSU High Risk Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID D. COLLINS (CFO, VP FINANCE & ADMINISTRATION)
(423) 439-5884
Entity
Organization
Contact information
Practice address
325 N STATE OF FRANKLIN RD, (GROUND FLOOR WITH PEDIATRICS), JOHNSON CITY, TN 37604-6062
(423) 439-4355
(423) 439-4607
Mailing address
PO BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4078
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/15/2008
Last updated
09/11/2008
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