Individual
KEAIRA JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 LAKE DR, SOMERVILLE, TN 38068-9709
(901) 738-2904
Mailing address
PO BOX 953, SOMERVILLE, TN 38068-0953
(901) 738-2904
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
108749539
TN
Other
Enumeration date
05/06/2025
Last updated
05/06/2025
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