Individual
HEATHER MOATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 SWARTHMORE LN, MARYVILLE, TN 37804-3428
(210) 364-6262
Mailing address
2010 SWARTHMORE LN, MARYVILLE, TN 37804-3428
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
86242
TN
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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