Organization
MICHAEL A. WOLF
Active
Organization
MICHAEL A. WOLF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ANTHONY WOLF O.D. (OWNER)
(423) 477-2020
Entity
Organization
Contact information
Practice address
122 OLD GRAY STATION RD, SUITE 1, GRAY, TN 37615-3434
(423) 477-2020
(423) 477-2196
Mailing address
122 OLD GRAY STATION RD, SUITE 1, GRAY, TN 37615-3434
(423) 477-2020
(423) 477-2196
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
OD0000001369
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3591864
—
TN
Enumeration date
02/12/2008
Last updated
02/12/2008
Update your record
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