Provider Demographics
NPI:1376971085
Name:QUALITY HEALTH CLINIC LLC
Entity type:Organization
Organization Name:QUALITY HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WADZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-679-5985
Mailing Address - Street 1:7348 MIDDLEBROOK PIKE D
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909
Mailing Address - Country:US
Mailing Address - Phone:865-679-5985
Mailing Address - Fax:865-381-1639
Practice Address - Street 1:7348 MIDDLEBROOK PIKE SUITE D
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909
Practice Address - Country:US
Practice Address - Phone:865-679-5985
Practice Address - Fax:865-381-1639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42480261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain