Individual
MRS. KATIE KORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
15 IRIS LN, CROSSVILLE, TN 38555-7528
(931) 456-2728
Mailing address
15 IRIS LN, CROSSVILLE, TN 38555-7528
(931) 456-2728
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0000000865
TN
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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