Individual
DEMETRUS COONROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1089 BAILEY AVE STE C3, CHATTANOOGA, TN 37404-2802
(423) 314-9897
Mailing address
1089 BAILEY AVE STE C3, CHATTANOOGA, TN 37404-2802
(423) 314-9897
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
76895155
TN
172A00000X
Driver
Primary
82108564
TN
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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