Individual
ROBERT BODHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 RUNNING DEER DR, DECATURVILLE, TN 38329-5285
(865) 216-6327
Mailing address
100 RUNNING DEER DR, DECATURVILLE, TN 38329-5285
(865) 216-6327
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2496
TN
Other
Enumeration date
04/04/2014
Last updated
02/25/2022
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