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1558856609
MID SOUTH PSYCH SERVICES, PLLC
BOLIVAR, TN
NPI
1558856609
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Entity Type
Organization
Authorized Contact
MARY JANE ALLEN
Owner
731-609-6096
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner Psychiatric/Mental Health
Enumeration Date
2018-06-29
Last Update Date
2018-06-29
Business Address
MID SOUTH PSYCH SERVICES, PLLC
206 STEVENS RD
BOLIVAR, TN 38008-1120
Phone number: 731-609-6096
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Mailing Address
MID SOUTH PSYCH SERVICES, PLLC
PO BOX 5777
MARYVILLE, TN 37802-5777
Phone number: 865-246-2104
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