Individual
KENNETH NIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15247 RANKIN AVE, DUNLAP, TN 37327
(423) 949-3937
(423) 949-7435
Mailing address
PO BOX 1449, DUNLAP, TN 37327
(423) 949-3937
(423) 949-7435
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT617
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3594241
—
TN
Enumeration date
08/22/2006
Last updated
10/24/2012
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