Individual
CARLOS LAVAY TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1107 POPPEN DR, MEMPHIS, TN 38111-2929
(901) 538-1078
Mailing address
1107 POPPEN DR, MEMPHIS, TN 38111-2929
(901) 538-1078
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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