Individual
MR. DEWAYNE DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPO
Contact information
Practice address
7002 SHALLOWFORD RD, CHATTANOOGA, TN 37421-1715
(423) 499-0810
Mailing address
5515 MILLSTONE DR, OOLTEWAH, TN 37363-6859
(423) 238-6821
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
TN0844
TN
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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