Provider Demographics
NPI:1437421146
Name:DYNAMIC MEDICAL CENTER OF MURFREESBORO PLC
Entity type:Organization
Organization Name:DYNAMIC MEDICAL CENTER OF MURFREESBORO PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-883-4761
Mailing Address - Street 1:210 ROBERT ROSE DR
Mailing Address - Street 2:STE D
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-6365
Mailing Address - Country:US
Mailing Address - Phone:615-225-9100
Mailing Address - Fax:615-225-9105
Practice Address - Street 1:210 ROBERT ROSE DR
Practice Address - Street 2:STE D
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-6365
Practice Address - Country:US
Practice Address - Phone:615-225-9100
Practice Address - Fax:615-225-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty