Provider Demographics
NPI:1821163056
Name:NEUROLOGY AND NEUROMUSCULAR CENTER PLC
Entity Type:Organization
Organization Name:NEUROLOGY AND NEUROMUSCULAR CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-552-7474
Mailing Address - Street 1:324 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-3422
Mailing Address - Country:US
Mailing Address - Phone:931-552-7474
Mailing Address - Fax:
Practice Address - Street 1:219 DUNBAR CAVE RD STE B
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8844
Practice Address - Country:US
Practice Address - Phone:931-552-7474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty