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Individual

KELVIN WASHINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
705 N JONES ST, BOLIVAR, TN 38008-1609
(501) 650-5661
Mailing address
705 N JONES ST, BOLIVAR, TN 38008-1609
(501) 650-5661

Taxonomy

Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
Primary
0016119
TN

Other

Enumeration date
10/08/2024
Last updated
11/08/2024
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