Individual
CHIQUITA WHITE-THOMASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 MOUNT MORIAH RD STE H212, MEMPHIS, TN 38115-1523
(901) 666-0810
Mailing address
2500 MOUNT MORIAH RD APT 104, MEMPHIS, TN 38115-1523
(901) 666-0810
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
200001553
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84-5020072
—
TN
Enumeration date
04/21/2020
Last updated
04/21/2020
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