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Individual

ORIS GEROME BOWEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5709 CEDAR ASH XING, ANTIOCH, TN 37013-2347
(615) 600-1217
Mailing address
5709 CEDAR ASH XING, ANTIOCH, TN 37013-2347
(615) 418-0322

Taxonomy

Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
203150
TN

Other

Enumeration date
07/12/2018
Last updated
07/12/2018
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