Individual
MICHAEL BRANDON CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1996 W STATE ST, BRISTOL, TN 37620-1940
(423) 844-6111
Mailing address
1996 W STATE ST, BRISTOL, TN 37620-1940
(423) 844-6111
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6152
TN
Other
Enumeration date
11/20/2016
Last updated
11/20/2016
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