Individual
RICKY DALE SHOWMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2830 HIGHWAY 394, BLOUNTVILLE, TN 37617-5577
(423) 274-6191
Mailing address
214 TUCKER HOLLOW RD, FALL BRANCH, TN 37656-2040
(423) 292-0251
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3617
TN
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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