Individual
MR. CHARLIE ANDREW TACITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1684 POPLAR AVE, MEMPHIS, TN 38104
(901) 278-1616
(901) 278-0144
Mailing address
PO BOX 77, MARION, AR 72364
(901) 278-1616
(901) 278-0144
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS0000010018
TN
Other
Enumeration date
01/10/2007
Last updated
04/02/2008
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