Individual
NICHOLAS ERIC RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT
Contact information
Practice address
1507 POPLAR ESTATES PKWY, GERMANTOWN, TN 38138-1840
(901) 828-1146
Mailing address
1507 POPLAR ESTATES PKWY, GERMANTOWN, TN 38138-1840
(901) 828-1146
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
200004323
TN
Other
Enumeration date
01/16/2021
Last updated
01/16/2021
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