Individual
MRS. LACIE DILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
103 W MAIN ST STE C, COOKEVILLE, TN 38506-2310
(931) 218-6463
Mailing address
2691 LACIE DR, COOKEVILLE, TN 38506-5078
(931) 265-4248
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2514
TN
Other
Enumeration date
04/16/2014
Last updated
05/01/2023
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