Organization
WAYNE E TASKER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IMOGENE DALTON (MANAGER)
(423) 581-8844
Entity
Organization
Contact information
Practice address
1329 W ANDREW JOHNSON HWY, MORRISTOWN, TN 37814-3728
(423) 581-8844
(423) 318-3050
Mailing address
1329 W ANDREW JOHNSON HWY, MORRISTOWN, TN 37814-3728
(423) 581-8844
(423) 318-3050
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW1208
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1513170
—
TN
01
—
36946802
GROUP MEDICARE #
TN
05
—
3730027
—
TN
Enumeration date
02/19/2007
Last updated
12/10/2012
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