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Individual

JEROME PATRICK TINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
155 JIM FORD RD, JONESBOROUGH, TN 37659-3129
(516) 967-0805
Mailing address
155 JIM FORD RD, JONESBOROUGH, TN 37659-3129
(516) 967-0805

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5240
TN

Other

Enumeration date
07/17/2022
Last updated
08/22/2025
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