| Ten Broeck Tennessee Physicians Group Inc | |
|
819 N 1st St Dennison OH 44621-1003 | |
| (740) 922-7415 | |
| (740) 922-7413 |
| Full Name | Ten Broeck Tennessee Physicians Group Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 819 N 1st St, Dennison, Ohio |
| Authorized Official Name and Position | Glenda F Guy (DIRECTOR, COMPLIANCE) |
| Authorized Official Contact | 9316076513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ten Broeck Tennessee Physicians Group Inc Po Box 1100 Windermere FL 34786-1100 Ph: (931) 607-6513 | Ten Broeck Tennessee Physicians Group Inc 819 N 1st St Dennison OH 44621-1003 Ph: (740) 922-7415 |
| NPI Number | 1265022974 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 01/26/2021 |
| Certification Date | 01/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265022974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |