LAKE COUNTY PRIMARY CARE

NPI # 

Practice Address:

710 Carl Perkins Pkwy

Tiptonville, TN, 38079-1678

Practice Phone:

731-253-6690

Practice Fax:

731-253-6692

License Number:

17394

License State:

TN

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X