Individual
RICKY TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9111 CROSS PARK DR, SUITE D200, KNOXVILLE, TN 37923-4506
(919) 394-4169
Mailing address
9111 CROSS PARK DR, SUITE D200, KNOXVILLE, TN 37923-4506
(804) 335-5997
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
TN
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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