Individual
CELESTE Y SORAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
271 MEDICAL PARK BLVD, BRISTOL, TN 37620-7455
(423) 968-2311
(423) 968-2109
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024171583
VA
363LF0000X
Family Nurse Practitioner
Primary
19149
TN
Other
Enumeration date
03/17/2014
Last updated
11/05/2014
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