Individual
PHYLLIS TUCKER KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 W 8TH ST, COOKEVILLE, TN 38505-0001
(931) 372-3320
(931) 372-3848
Mailing address
4627 RICKMAN RD, COOKEVILLE, TN 38506-7731
(931) 498-3642
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33008
TN
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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