Individual
MICHAEL D. HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8111 HIXSON PIKE STE A, HIXSON, TN 37343-1551
(423) 498-4342
Mailing address
11229 HIXSON PIKE LOT 11, SODDY DAISY, TN 37379-5723
(423) 902-3396
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT0000012214
TN
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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