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Organization

AMG-SOUTHERN TENNESSEE LLC

Active
Parent organization
AMG-SOUTHERN TENNESSEE LLC
Other names
Coalmont Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
AMG-SOUTHERN TENNESSEE LLC
Authorized official
WILLIAM GRACEY (COO)
(615) 372-8500
Entity
Organization

Contact information

Practice address
68 SOUTH INDUSTRIAL PARK ROAD, COALMONT, TN 37313
(931) 692-0010
(931) 692-0012
Mailing address
PO BOX 68, COALMONT, TN 37313-0068
(931) 692-0010
(931) 692-0012

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Enumeration date
06/20/2008
Last updated
06/20/2008
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