Leitherland Family Care Clinic, PLLC

Organization Active NPI Primary Care Clinic/Center · Dyer, TN

NPI 1376712448 · NPPES record last updated Mar 24, 2008

Key facts

NPI
1376712448
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
License
APN5603 (TN)
Legal business name
LEITHERLAND FAMILY CARE CLINIC, PLLC
Practice address
1123 N Main St
Dyer, TN 38330-1019
Phone
(731) 692-2853
Fax
(731) 692-2367
NPI assigned
Feb 22, 2008
Organization subpart
No

Authorized official

Name
Edna R Leitherland, FNP.C
Title
Owner
Phone
(731) 692-2853

National Provider Directory

Locations

1123 N Main St
Dyer, TN 38330
Phone (731) 692-2853

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X APN5603 TN Yes
Primary Care Clinic/Center 261QP2300X RN53289 TN

Addresses

Primary practice location

1123 N Main St
Dyer, TN 38330-1019

Mailing address

1123 N Main St
Dyer, TN 38330-1019
Phone (731) 692-2853

Other identifiers

IdentifierTypeStateIssuer
S66580OtherTNUPIN

Other providers in Dyer, TN

All providers in Dyer, TN · Primary Care Clinic/Center in Tennessee

Sources for this page

Verify at the official NPI Registry.