Individual
KIMBRA W HUMERICKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
875 UNION AVE # C517, MEMPHIS, TN 38103-3513
(901) 448-1848
Mailing address
170 HUNTINGTON DR, ROSSVILLE, TN 38066-3884
(901) 262-4129
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2695
TN
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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