Individual
STEPHANIE CALVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
782 COLLEGE ST, PORTLAND, TN 37148-2120
(615) 323-9464
Mailing address
782 COLLEGE ST, PORTLAND, TN 37148-2120
(615) 323-9464
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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