Individual
TALON FREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22510 ALBERTA ST, ONEIDA, TN 37841-3802
(865) 525-0391
(865) 525-0393
Mailing address
301 S PERIMETER PARK DR, SUITE 210, NASHVILLE, TN 37211-4143
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/10/2016
Last updated
01/10/2016
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