Organization
INTEGRATED FACIAL AESTHETICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY HICKERSON (CREDENTIALING FACILITATOR)
(931) 461-5056
Entity
Organization
Contact information
Practice address
1821 N WASHINGTON ST, TULLAHOMA, TN 37388-2221
(931) 455-2005
(931) 455-4450
Mailing address
1821 N WASHINGTON ST, TULLAHOMA, TN 37388-2221
(931) 455-2005
(931) 455-4450
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
02/11/2026
Last updated
02/11/2026
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