Individual
MARY GRACE MCCUBBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1764 GALLATIN PIKE N, PEARLE VISION, MADISON, TN 37115-2122
(615) 865-8412
(615) 865-8470
Mailing address
9186 OREGON RD, LASCASSAS, TN 37085-4430
(615) 273-2330
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000002902
TN
Other
Enumeration date
08/26/2009
Last updated
06/17/2011
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