Organization
SHAPE SHIFTERS WEIGHT LOSS AND JOINT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY BETH BYRD APRN (OWNER)
(423) 335-3077
Entity
Organization
Contact information
Practice address
104 UNIVERSITY PKWY STE 1, JOHNSON CITY, TN 37604-7349
(423) 335-3077
Mailing address
104 UNIVERSITY PKWY STE 1, JOHNSON CITY, TN 37604-7349
(423) 335-3077
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/26/2019
Last updated
12/26/2019
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