Individual
TINA FLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 W POPLAR AVE STE 112, COLLIERVILLE, TN 38017-2687
(901) 850-0811
Mailing address
1016 W POPLAR AVE STE 112, COLLIERVILLE, TN 38017-2687
(901) 850-0811
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DPO482
TN
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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