Individual
GRACE FAITH BAIZA TAOATAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1591 DEXTER LAKE DR APT 304, CORDOVA, TN 38016-1305
(901) 849-0219
Mailing address
1591 DEXTER LAKE DR APT 304, CORDOVA, TN 38016-1305
(901) 849-0219
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
004427
TN
225200000X
Physical Therapy Assistant
Primary
4427
TN
Other
Enumeration date
07/06/2011
Last updated
04/17/2019
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