Individual
ANGELA LAROSE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1076 CHAMBLISS RD, MEMPHIS, TN 38116-6381
(901) 348-2273
Mailing address
3274 LANSING DR, MEMPHIS, TN 38115-3016
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
227
TN
Other
Enumeration date
08/13/2008
Last updated
08/13/2008
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