Individual
KELLY LANE DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 CHESTER HARRIS RD, WOODLAWN, TN 37191-9054
(931) 552-8964
Mailing address
2425 CHESTER HARRIS RD, WOODLAWN, TN 37191-9054
(931) 552-8964
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
CXT0000000596
TN
247200000X
Other Technician
Primary
CTA0000000761
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CTA0000000761
CHIROPRACTIC THERAPY ASSISTANT
TN
01
—
CXT0000000596
CHIROPRACTIC X-RAY TECHNOLOGIST
TN
Enumeration date
02/11/2009
Last updated
02/11/2009
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