Individual
CIELO YAMBAO REMORQUE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
9012 JOHNSTON ST, CORDOVA, TN 38016-3587
(901) 751-1658
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4694
TN
Other
Enumeration date
12/05/2006
Last updated
07/12/2007
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