Individual
DIAMOND MEADOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
917 W WALNUT ST, JOHNSON CITY, TN 37604-6527
(423) 439-6464
Mailing address
1317 CORA LN APT 3, JOHNSON CITY, TN 37615-4750
(203) 997-5246
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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