FAMILY CLINIC AT THE LAKE PLLC is a rural health clinic center in Counce, TN. FAMILY CLINIC AT THE LAKE PLLC NPI is 1578125647. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
11268 HIGHWAY 57
COUNCE, TN
ZIP 38326-802
Phone: (731) 689-4357
The provider's authorized official is Ellanikole Jackson .
The authorized official title is Owner and has the following contact phone number (731) 689-4357.
The CLIA number assigned to this NPI record is 44D2133307 - rural health clinic with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/28/2019 and was last updated on 10/14/2019.