Individual
JUDY CAROLYN BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 WILLARD ST, FAYETTEVILLE, TN 37334-3041
(931) 438-8299
Mailing address
111 MEDIUM CEMETERY RD, PETERSBURG, TN 37144-7802
(931) 438-8299
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2665
TN
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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