Organization
AMG CROCKETT LLC
Active
Other names
Southern Tennessee Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY WILLIS (MANAGER)
(931) 766-4574
Entity
Organization
Contact information
Practice address
1009 N LOCUST AVE, LAWRENCEBURG, TN 38464-2746
(931) 762-0531
(931) 762-0998
Mailing address
1009 N LOCUST AVE, LAWRENCEBURG, TN 38464-2746
(931) 762-0531
(931) 762-0998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/29/2015
Last updated
05/29/2015
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