Individual
DARRELL FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 PAVILION DR, KINGSPORT, TN 37660-4622
(423) 741-7116
Mailing address
2300 PAVILION DR, KINGSPORT, TN 37660-4622
(423) 741-7116
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7608
TN
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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