Individual
STACIE MCCORKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1335 NW BROAD ST, MURFREESBORO, TN 37129-4428
(620) 704-0637
Mailing address
1335 NW BROAD ST, MURFREESBORO, TN 37129-4428
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1402624
KS
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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