Provider Demographics
NPI:1891146338
Name:MCGLOFFIN, LYRIC
Entity Type:Individual
Prefix:
First Name:LYRIC
Middle Name:
Last Name:MCGLOFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8466 ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:TN
Mailing Address - Zip Code:38474-1923
Mailing Address - Country:US
Mailing Address - Phone:931-374-1127
Mailing Address - Fax:
Practice Address - Street 1:8466 ENTERPRISE ROAD
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:TN
Practice Address - Zip Code:38474-4020
Practice Address - Country:US
Practice Address - Phone:931-374-1127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider