Individual
KACEY BROOKE CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
536 MAIN ST W, MT CARMEL, TN 37645-3564
(423) 256-3232
Mailing address
536 MAIN ST W, MT CARMEL, TN 37645-3564
(423) 256-3232
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3080
TN
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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