Individual
CAROLYN D LEWALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
895 POWERS BLVD, WAVERLY, TN 37185-1018
(931) 296-7552
Mailing address
895 POWERS BLVD, WAVERLY, TN 37185-1018
(931) 296-7552
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0686
TN
Other
Enumeration date
05/07/2013
Last updated
05/07/2013
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