Individual
ZACHARY REAGAN RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
206 COPPER RIDGE TRL, ROCKVALE, TN 37153-4655
(615) 653-9620
Mailing address
206 COPPER RIDGE TRL, ROCKVALE, TN 37153-4655
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0000006984
TN
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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