Organization Name: | TARRIA O. MCNEAL |
NPI Number: | 1013179415 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TARRIA O MCNEAL (OWNER/ CEO) |
Mailing Address: | 901 12th Ave S Suite 5 Nashville |
State: | TN US |
Postal Code: | 372034705 |
Phone Number: | 6152916700 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2008 |
NPI Last Update Date: | 08/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |