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Individual

MR. KENDALL ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3720 ALUMNI AVE, MEMPHIS, TN 38111-5914
(901) 678-2000
Mailing address
159 LORAINE RD, MEMPHIS, TN 38109-8513

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01
EMPLOYER
Enumeration date
06/22/2022
Last updated
06/22/2022
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