institution
East Tennessee State University
Federally Qualified Health Center (FQHC) in Johnson City, Tennessee
NPI 1093990608

East Tennessee State University is a Federally Qualified Health Center (FQHC) based in Johnson City, TN and is specialized in Federally Qualified Health Center (FQHC). East Tennessee State University practices in Johnson City, TN. The NPI Number for East Tennessee State University is 1093990608 and holds a License No. (Tennessee).

The current practice location address for East Tennessee State University is 202 W Fairview Ave, Johnson City, TN and can be reached out via phone at 423-434-0894 and via fax at 423-434-0666.

Location: 202 W Fairview Ave, Johnson City, TN, 37614-1703
institution
Provider Profile Details
NPI Number
1093990608
Provider Name
East Tennessee State University
Credential
Provider Entity Type
Organization
Address
202 W Fairview Ave, Johnson City, TN, 37614-1703
Phone Number
423-434-0894
Fax Number
423-434-0666
Provider Enumeration Date
01/02/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
202 W Fairview Ave
City
State
Zip
37604-5611
Phone Number
423-434-0894
Fax Number
423-434-0666
person
Provider Business Mailing Address Details
Address
202 W Fairview Ave
City
State
Zip
37604-5611
Phone Number
423-434-0894
Fax Number
423-434-0666
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
()
Definition
Definition to come...
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