Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Feb 25, 2011
License(s)
15648 (TN)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 301 MED TECH PKWY STE 240 | Johnson City, TN 37604-2641 | 423-794-5520 |
| MAILING | PO BOX 632476 | Cincinnati, OH 45263-2476 | 423-794-5520 |
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