Individual
MRS. DONNA RACHEL HEADRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
323 FOX RD, SUITE 200, KNOXVILLE, TN 37922-3383
(865) 690-5231
Mailing address
1366 CLOYDS CH. RD., GREENBACK, TN 37742
(865) 856-7429
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
DA0000006577
TN
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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