Individual
DEANA WILDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
235 LAFOLLETTE CIR, PIGEON FORGE, TN 37863-3207
(865) 659-8803
Mailing address
235 LAFOLLETTE CIR, PIGEON FORGE, TN 37863-3207
(865) 659-8803
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
TN
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
10/22/2024
Last updated
10/24/2024
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