Individual
WENDY RENEE COLLINS SQUIREWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
612 W DUE WEST AVE # G100, MADISON, TN 37115-4402
(615) 258-1990
(615) 258-1992
Mailing address
215 SAVANNAH COURT EAST, SPRINGFIELD, TN 37172
(615) 579-0819
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
079013609
TN
Other
Enumeration date
10/23/2019
Last updated
03/09/2022
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