Individual
MR. BENJAMIN DYLAN SHORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
404 S WHITE ST, ATHENS, TN 37303-4732
(865) 525-0391
(865) 525-0393
Mailing address
301 S PERIMETER PARK DR STE 210, NASHVILLE, TN 37211-4128
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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