Individual
MR. TERRENCE DESHON FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1657 BELLEDEER DR E, CORDOVA, TN 38016-0429
(901) 483-4575
Mailing address
1657 BELLEDEER DR E, CORDOVA, TN 38016-0429
(901) 483-4575
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
110006378
TN
Other
Enumeration date
06/17/2012
Last updated
06/17/2012
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