Individual
MR. LARRY ERNEST GERDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
333 MURFREESBORO RD, NASHVILLE, TN 37210-2834
(615) 248-1261
(615) 248-1622
Mailing address
4010 WELLINGTON CT, OLD HICKORY, TN 37138-4657
(615) 758-0476
(615) 248-1622
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000001329
TN
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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