| Eastlake Medical, Llc | |
|
2205 Jacksboro Pike La Follette TN 37766-2904 | |
| (423) 352-6500 | |
| (423) 352-6501 |
| Full Name | Eastlake Medical, Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 2205 Jacksboro Pike, La Follette, Tennessee |
| Authorized Official Name and Position | Valerie Lynn Miesel (OWNER) |
| Authorized Official Contact | 4233526500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastlake Medical, Llc 2205 Jacksboro Pike La Follette TN 37766-2904 Ph: (423) 352-6500 | Eastlake Medical, Llc 2205 Jacksboro Pike La Follette TN 37766-2904 Ph: (423) 352-6500 |
| NPI Number | 1205690153 |
|---|---|
| Provider Enumeration Date | 02/12/2024 |
| Last Update Date | 02/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205690153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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