Individual
DULCIE A CHAMPION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 STEELES RD, BRISTOL, TN 37620-9532
(423) 844-6700
(423) 844-6703
Mailing address
350 STEELES RD, BRISTOL, TN 37620-9532
(423) 844-6700
(423) 844-6703
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA306
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1513353
TN CARE PN
TN
01
—
PA306
LICENSE NUMBER
TN
Enumeration date
03/22/2007
Last updated
03/02/2010
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