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Individual

VIVIAN MANDAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
800 OAK RIDGE TPKE STE C100, OAK RIDGE, TN 37830-6927
(865) 483-2288
Mailing address
2733 SILICON VALLEY WAY, KNOXVILLE, TN 37931-4288
(347) 981-3905

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TN
363AS0400X
Surgical Physician Assistant
TN

Other

Enumeration date
02/12/2024
Last updated
02/21/2024
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