Organization
THE WOUND PRACTITIONER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSELLA SMALLEY APN (SOLE PROPRIETER)
(865) 466-0768
Entity
Organization
Contact information
Practice address
2415 N GATEWAY AVE, HARRIMAN, TN 37748-8609
(865) 882-2442
Mailing address
319 BLUFF RD, KINGSTON, TN 37763-7231
(865) 466-0768
(865) 717-1113
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
APN0000010924
TN
Other
Enumeration date
07/15/2006
Last updated
08/22/2020
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