Individual
MR. DONOVAN C MCLEOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4704 KENWOOD AVE, CHATTANOOGA, TN 37411-3805
(423) 505-7866
Mailing address
PO BOX 80925, CHATTANOOGA, TN 37414-7925
(423) 505-7866
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
L000000026251
TN
Other
Enumeration date
03/14/2021
Last updated
03/14/2021
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