Individual
JEREMY FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 MEDICAL CT, CLARKSVILLE, TN 37043-4602
(931) 648-8015
Mailing address
2526 JARRELL RIDGE RD, CLARKSVILLE, TN 37043-8343
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12522
TN
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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