Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Other names
ETSU Speech & Hearing Center
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
156 S DOSSETT DRIVE, JOHNSON CITY, TN 37614-1702
(423) 439-4584
(423) 439-4607
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3714470
—
TN
Enumeration date
07/04/2006
Last updated
05/03/2019
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