Individual
JASON DEWAYNE SANDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5310 BALL CAMP PIKE, KNOXVILLE, TN 37921-3234
(865) 523-4704
Mailing address
201 W SPRINGDALE AVE, KNOXVILLE, TN 37917-5158
(865) 637-9711
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN00000067088
TN
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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