Individual
TIFFANY CLEGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3620 MCDONALD RD, KNOXVILLE, TN 37914-6215
(865) 964-8132
Mailing address
3620 MCDONALD RD, KNOXVILLE, TN 37914-6215
(865) 964-8132
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1000000028464
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85-0821925
IRS
TN
Enumeration date
05/04/2021
Last updated
05/04/2021
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