Provider Demographics
NPI:1831640937
Name:WATAUGA RECOVERY CENTER MORRISTOWN P.C.
Entity Type:Organization
Organization Name:WATAUGA RECOVERY CENTER MORRISTOWN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LINKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-431-0432
Mailing Address - Street 1:1369 W ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814
Mailing Address - Country:US
Mailing Address - Phone:423-586-3249
Mailing Address - Fax:423-586-3250
Practice Address - Street 1:1369 W ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-586-3249
Practice Address - Fax:423-586-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty