Ultimate Health Clinic Pc

NPI 1669567707 - Internal Medicine - 207R00000X

NPI Details
NPI 1669567707
Enumeration Date 10/04/2006
Last Updated 06/03/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name SAMUEL OLANIYI SAMUEL
Position OWNER
Phone (731) 265-1997
Fax (731) 265-0511
Practice Location
1673 N ROYAL ST
JACKSON TN, 38301-3607, US
Phone (731) 265-1997
Fax (731) 265-0511
Business Location
PO BOX 10156
JACKSON TN, 38308-0102, US
Phone (731) 265-1997
Fax (731) 265-0511
Toxanomy
Taxonomy Code 207R00000X
License State
License Number
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According to our database, Ultimate Health Clinic Pc NPI is 1669567707, taxonomy code is 207R00000X Ultimate Health Clinic Pc physically located at 1673 N Royal St, Jackson TN, 38301-3607. NPI Number 1033115704 has the healthcare provider type.

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1669567707 NPI number is provided on an as is basis without warranty of any kind. 1669567707 is maintained by the National Plan & Provider Enumeration System. The contents of Ultimate Health Clinic Pc are for informational purposes only.