Individual
MARIANNA RUTHERFORD VESCOVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7205 WOLF RIVER BLVD STE 155, GERMANTOWN, TN 38138-1758
(901) 322-7020
Mailing address
4760 LINDA LN, MEMPHIS, TN 38117-2512
(901) 428-5194
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
664256220
TN
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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