Individual
MR. ERNEST DISMUKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT R/L
Contact information
Practice address
601 WOODHAVEN DR, SMYRNA, TN 37167-4179
(615) 594-1075
(615) 220-2358
Mailing address
601 WOODHAVEN DR, SMYRNA, TN 37167-4179
(615) 594-1075
(615) 220-2358
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3072
TN
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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