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Individual

MRS. TONYA C. KRANTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1822 MEMORIAL DR, CLARKSVILLE, TN 37043-4605
(931) 552-8012
(931) 551-3118
Mailing address
1822 MEMORIAL DR, CLARKSVILLE, TN 37043-4605
(931) 552-8012
(931) 551-3118

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000263
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3728817
TN
01
4102314
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/29/2007
Last updated
07/08/2007
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