Individual
DAVA MACKENSIE TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
920 MADISON AVE STE 447, MEMPHIS, TN 38103-3438
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/18/2024
Last updated
04/18/2024
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