Individual
GAIGE TYCEAN KIMBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8233 FALLEN ROCK DR, KNOXVILLE, TN 37923-1215
(318) 548-1188
Mailing address
8233 FALLEN ROCK DR, KNOXVILLE, TN 37923-1215
(318) 548-1188
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
106S00000X
TN
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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