Individual
MS. LAURIE L. MCBRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
180 W UNIVERSITY PKWY STE H, JACKSON, TN 38305-1612
(731) 660-2065
(731) 660-2066
Mailing address
79 PASTURE RD, LEXINGTON, TN 38351-3120
(731) 967-2369
(731) 660-2066
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PTA0000001872
TN
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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