Individual
DR. GARY BLAINE WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D., A.T.C.
Contact information
Practice address
615 MCCALLIE AVE, DEPARTMENT 6606, CHATTANOOGA, TN 37403-2504
(423) 425-5394
(423) 425-5395
Mailing address
9 BIG ROCK RD, SIGNAL MOUNTAIN, TN 37377-2007
(423) 886-2998
(423) 425-5395
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000000502
TN
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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