Provider Demographics
NPI:1962814889
Name:BEST WEIGH WEIGHT LOSS CENTER LLC
Entity Type:Organization
Organization Name:BEST WEIGH WEIGHT LOSS CENTER LLC
Other - Org Name:(CROSSVILLE)
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-319-9053
Mailing Address - Street 1:3759 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0707
Mailing Address - Country:US
Mailing Address - Phone:931-319-9053
Mailing Address - Fax:
Practice Address - Street 1:80 MILLER AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-6059
Practice Address - Country:US
Practice Address - Phone:931-707-7333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000001336363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty