Individual
SARRAH WIDATALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
944 21ST AVE N APT 802, NASHVILLE, TN 37208-3456
(615) 717-4174
Mailing address
422 MILLWOOD DR, NASHVILLE, TN 37217-1605
(615) 717-4174
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
Primary
190538
TN
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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