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Individual

DARRELL LEE KIRTLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
806 SAM HOUSTON SCHOOL RD, MARYVILLE, TN 37804-5632
(865) 719-1315
Mailing address
806 SAM HOUSTON SCHOOL RD, MARYVILLE, TN 37804-5632
(865) 719-1315

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0000108065
TN

Other

Enumeration date
07/09/2019
Last updated
07/09/2019
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