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Individual

AUDREY W COO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2225 UNION AVE, SUITE 100, MEMPHIS, TN 38104-4316
(901) 726-1161
(901) 726-0161
Mailing address
2225 UNION AVE, SUITE 100, MEMPHIS, TN 38104-4316
(901) 726-1161
(901) 726-0161

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD29587
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3814497
TN
Enumeration date
08/02/2005
Last updated
07/08/2007
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