| Alison Knack Pc Inc | |
|
79 Highway 51 S Ripley TN 38063-4580 | |
| (479) 841-1814 | |
| Not Available |
| Full Name | Alison Knack Pc Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 79 Highway 51 S, Ripley, Tennessee |
| Authorized Official Name and Position | Alison Knack (OWNER) |
| Authorized Official Contact | 4798411814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alison Knack Pc Inc 218 Division Ave Jackson TN 38301-4841 Ph: (479) 841-1814 | Alison Knack Pc Inc 79 Highway 51 S Ripley TN 38063-4580 Ph: (479) 841-1814 |
| NPI Number | 1245854991 |
|---|---|
| Provider Enumeration Date | 05/28/2020 |
| Last Update Date | 05/28/2020 |
| Certification Date | 05/28/2020 |
| Medicare PECOS PAC ID | 7911329073 |
|---|---|
| Medicare Enrollment ID | O20200617003057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245854991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Alison Knack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700423365 PECOS PAC ID: 9234551532 Enrollment ID: I20200615001384 |
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