Individual
TIFFANY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
H.IS
Contact information
Practice address
4515 POPLAR AVE STE 108-B, MEMPHIS, TN 38117-7503
(901) 767-3045
(901) 767-3046
Mailing address
679 S MENDENHALL RD, MEMPHIS, TN 38117-5212
(901) 767-3045
(901) 767-3046
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
598
MS
174400000X
Specialist
Primary
749
TN
Other
Enumeration date
01/17/2019
Last updated
07/27/2023
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