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Individual

DAVID A SELF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
2700 WESTSIDE DR NW, SUITE 301, CLEVELAND, TN 37312-3699
(423) 479-3600
(423) 303-1234
Mailing address
2700 WESTSIDE DR NW, SUITE 301, CLEVELAND, TN 37312-3699
(423) 479-3600
(423) 303-1234

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5299
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4096931
BCBS OF TN
TN
Enumeration date
12/15/2006
Last updated
11/19/2008
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