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Individual

DERRICK HOWERTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4951 BRIGHTON LN, HIXSON, TN 37343-4260
(423) 255-9657
Mailing address
4951 BRIGHTON LN, HIXSON, TN 37343-4260
(423) 255-9657

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
TN
347C00000X
Private Vehicle

Other

Enumeration date
09/21/2016
Last updated
09/21/2016
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