Individual
REDENTOR GOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6685 HIGHWAY 64 STE 2, OAKLAND, TN 38060-3402
(901) 465-7850
Mailing address
6685 HIGHWAY 64 STE 2, OAKLAND, TN 38060-3402
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 4082
TN
Other
Enumeration date
01/27/2007
Last updated
07/08/2007
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