Organization
TULLAHOMA DERMATOLOGY PC
Active
Organization
TULLAHOMA DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC BRYAN (PRESIDENT)
(509) 426-4985
Entity
Organization
Contact information
Practice address
1330 CEDAR LN STE 700, TULLAHOMA, TN 37388-3276
(931) 455-7400
Mailing address
1330 CEDAR LN STE 700, TULLAHOMA, TN 37388-3276
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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