Individual
MIA SCULLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8809 FOREST BREEZE DR, CORDOVA, TN 38018-7692
(901) 691-6274
Mailing address
8809 FOREST BREEZE DR, CORDOVA, TN 38018-7692
(901) 691-6274
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
TN
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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