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Individual

DANIEL DEVINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3000 MALL ROAD NORTH, KNOXVILLE CENTER MALL, KNOXVILLE, TN 37924
(865) 521-3747
Mailing address
1201 RAMBLING CT, GREENEVILLE, TN 37743-6635
(423) 639-3187

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1774
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010300568
VA
05
3942583
TN
05
39425841
TN
Enumeration date
11/13/2006
Last updated
05/08/2008
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