Individual
PAM WINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6215 ST ANDREWS WAY, HIXSON, TN 37343-3293
(423) 645-1843
Mailing address
6215 ST ANDREWS WAY, HIXSON, TN 37343-3293
(423) 645-1843
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5171
TN
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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