Individual
JUSTIN PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2158 NORTHGATE PARK LN STE 200, CHATTANOOGA, TN 37415-6911
(423) 254-5461
Mailing address
625 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15130
TN
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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