Individual
CAMERON ISAIAH GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
514 LOYSTON RD, MAYNARDVILLE, TN 37807-2200
(254) 768-4740
Mailing address
514 LOYSTON RD, MAYNARDVILLE, TN 37807-2200
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372500000X
Chore Provider
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
12/11/2020
Last updated
12/14/2020
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