Individual
KIMBERLY FAWVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
PMB 363 710 HWY 51 BYPASS, DYERSBURG, TN 38024
(731) 286-4300
(731) 286-8008
Mailing address
1950 COOK ST, DYERSBURG, TN 38024-1899
(731) 286-4300
(731) 286-8008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1290
TN
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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