Provider Demographics
NPI:1508301086
Name:J & L ENTERPRISES, LLC
Entity Type:Organization
Organization Name:J & L ENTERPRISES, LLC
Other - Org Name:MEDICAL SPECIALTIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:423-790-7792
Mailing Address - Street 1:PO BOX 1765
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30722-1765
Mailing Address - Country:US
Mailing Address - Phone:706-271-0100
Mailing Address - Fax:706-270-0487
Practice Address - Street 1:110 DUNHILL PL NW
Practice Address - Street 2:SUITE B
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3866
Practice Address - Country:US
Practice Address - Phone:423-790-7792
Practice Address - Fax:706-270-0487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty