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Individual

BENJAMIN MICHAEL CHALSTROM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5150 N BROADWAY ST, KNOXVILLE, TN 37918-2342
(865) 549-5111
Mailing address
1517 GREYTOWN WAY APT 305, KNOXVILLE, TN 37932-3436
(307) 630-5417

Taxonomy

Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary

Other

Enumeration date
01/11/2023
Last updated
01/11/2023
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