Individual
PAMELA LYNN COSGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
57 FAIRFIELD BLVD, CROSSVILLE, TN 38558-4417
(931) 484-3344
(931) 456-3671
Mailing address
57 FAIRFIELD BLVD, CROSSVILLE, TN 38558-4417
(931) 484-3344
(931) 456-3671
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1477
TN
152W00000X
Optometrist
OPC03074
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620283700
—
FL
05
—
Q053998
—
TN
Enumeration date
10/24/2005
Last updated
04/04/2022
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