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Individual

MR. GARY WAYNE TOTTEN-EMERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPS

Contact information

Practice address
882 UNION ST, SHELBYVILLE, TN 37160-2614
(615) 426-6144
Mailing address
410 MAPLE ST W, FAYETTEVILLE, TN 37334-3337
(615) 426-6144

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
01/07/2009
Last updated
01/07/2009
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