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Individual

BENNY TATE FOSTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
611 AIRBASE LN, BRICEVILLE, TN 37710-2023
(865) 748-8715
Mailing address
611 AIRBASE LN, BRICEVILLE, TN 37710-2023
(865) 748-8715

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
0145794
TN

Other

Enumeration date
11/26/2024
Last updated
11/26/2024
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