Organization
SOUTHEASTERN SWALLOWING DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA STOUT (CO-OWNER/THERAPIST)
(229) 318-9594
Entity
Organization
Contact information
Practice address
8459 LEXIE LN, OOLTEWAH, TN 37363-5796
(301) 275-4057
Mailing address
8459 LEXIE LN, OOLTEWAH, TN 37363-5796
(301) 275-4057
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
03/08/2017
Last updated
10/03/2018
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