Individual
DEKE BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
920 MADISON AVE STE 447, MEMPHIS, TN 38103-3438
(901) 448-2782
Mailing address
847 MONROE AVE STE 427, MEMPHIS, TN 38103-4901
(901) 448-6375
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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