Individual
ANTHONY G TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2707 N CHAMBERLAIN AVE, CHATTANOOGA, TN 37406-2506
(423) 682-5991
Mailing address
2707 N CHAMBERLAIN AVE, CHATTANOOGA, TN 37406-2506
(423) 682-5991
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
831501033
FEIN
TN
Enumeration date
08/30/2018
Last updated
08/30/2018
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