Individual
AMANDA ELLICE JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 ADAMS LN, OAK RIDGE, TN 37830-4909
(865) 483-7743
Mailing address
201 W SPRINGDALE AVE, KNOXVILLE, TN 37917-5158
(865) 637-9711
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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