Individual
ALICE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1233 SOUTHWEST AVE, JOHNSON CITY, TN 37604-6596
(423) 979-4616
Mailing address
1182 HIGHWAY 107, JONESBOROUGH, TN 37659-7212
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
0000071331
TN
Other
Enumeration date
05/04/2010
Last updated
05/04/2010
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