Individual
MEGA CLARE VANDENBERGH PURINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
353 NEW SHACKLE ISLAND RD, SUITE 141-C, HENDERSONVILLE, TN 37075-2379
(615) 826-3142
(615) 447-1060
Mailing address
353 NEW SHACKLE ISLAND RD, SUITE 141-C, HENDERSONVILLE, TN 37075-2379
(615) 826-3142
(615) 447-1060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
748
TN
Other
Enumeration date
03/12/2009
Last updated
03/12/2009
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