Individual
MR. ANDREW LOUIS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
1734 MADISON AVE, MEMPHIS, TN 38104-6414
(901) 722-9420
Mailing address
1734 MADISON AVE, MEMPHIS, TN 38104-6414
(901) 722-9420
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0000000945
TN
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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