Individual
RITIN BOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
995 S YATES RD STE 2, MEMPHIS, TN 38119-0882
(901) 979-4140
(901) 979-8151
Mailing address
PO BOX 691, PARIS, TN 38242-0691
(901) 979-4140
(901) 979-8151
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
54823
TN
Other
Enumeration date
07/09/2010
Last updated
02/07/2024
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