EXCELSIOR PODIATRY CLINIC PLLC

SOMERVILLE, TN
NPI1124350087
Entity TypeOrganization
Authorized ContactJOHN ELIJAH BELL
CEO, President
901-516-4005
Organization Subpart ?No
Primary Taxonomy302F00000X Exclusive Provider Organization
(Licence: TN  DPM0000000649)
Enumeration Date2010-02-03
Last Update Date2010-02-03
Business Address
EXCELSIOR PODIATRY CLINIC PLLC
214 LAKEVIEW RD
SOMERVILLE, TN 38068-9737
Phone number: 901-516-4005
Mailing Address
EXCELSIOR PODIATRY CLINIC PLLC
PO BOX 460
OAKLAND, TN 38060-0460
Phone number: 901-516-4005