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Individual

JOHN J MARIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1306 DONELSON PKWY, DOVER, TN 37058-3753
(931) 232-5118
(931) 232-0581
Mailing address
1306 DONELSON PKWY, DOVER, TN 37058-3753
(931) 232-5118
(931) 232-0581

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TN1471
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TN1471
STATE LICENSE NUMBER
TN
Enumeration date
07/09/2006
Last updated
07/08/2007
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