Individual
MR. JOHNNY WINFRED STAGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 DYER ST, SUITE 1, COLUMBIA, TN 38401-4551
(931) 560-4239
Mailing address
1031 HIGHWAY 100, APT 8, CENTERVILLE, TN 37033-1199
(931) 994-2812
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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