| Organization Name: | MCMINNVILLE MEDICAL CARE CENTER LLC |
| NPI Number: | 1164546057 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONALD EUGENE KRIEGEL (OWNER) |
| Mailing Address: | 457 N Chancery St Mc Minnville |
| State: | TN US |
| Postal Code: | 371102049 |
| Phone Number: | 9314746622 |
| Fax Number: | 9314746625 |
| NPI Enumeration Date: | 03/18/2007 |
| NPI Last Update Date: | 01/31/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |