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Individual

JACOB MATTHEW GELDRICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2127 ACADEMY WAY, LA VERGNE, TN 37086-3821
(865) 680-6061
Mailing address
2127 ACADEMY WAY, LAVERGNE, TN 37086-0000
(865) 680-6061

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0000014614
TN

Other

Enumeration date
12/31/2009
Last updated
02/16/2010
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