NPI 1962915652
Mountain States Health Alliance
Practice location
- Address
- 400 N State of Franklin Rd, Johnson City, TN 37604-6035
- Phone
- (423) 431-6111
- Fax
- (423) 431-3549
- Mailing address
- 311 Princeton Rd STE 1, Johnson City, TN 37601-2026
Authorised official
- Name
- Mary Lynn Krutak
- Title
- Evp/Cfo
- Phone
- (423) 302-3423
Registered specialties
Psychiatric Hospital Unit
Primary
Registry record
- NPI
- 1962915652
- Entity type
- Organization
- NPI issued
- 16 Nov 2017
- Record last updated
- 14 Mar 2018
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.