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1396216339
FOUNTAIN OF YOUTH MEDICAL LLC
KNOXVILLE, TN
NPI
1396216339
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Entity Type
Organization
Authorized Contact
GENEVA LYNNE WORTHINGTON
Fnp C
865-392-1500
Organization Subpart ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
Enumeration Date
2018-12-17
Last Update Date
2019-03-06
Business Address
FOUNTAIN OF YOUTH MEDICAL LLC
135 LOVELL RD
KNOXVILLE, TN 37934-1904
Phone number: 865-392-1400
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Mailing Address
FOUNTAIN OF YOUTH MEDICAL LLC
135 LOVELL RD
KNOXVILLE, TN 37934-1904
Phone number: 865-392-1500
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