Individual
TRAVIS RAY WALDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3105 ESSARY DR, KNOXVILLE, TN 37918-2409
(865) 637-9711
Mailing address
200 TECH CENTER DR, KNOXVILLE, TN 37912-2747
(865) 637-9711
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
100491
TN
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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