Individual
ANCHIO LATWAN WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
933 MAPLE ST, KINGSPORT, TN 37660-5219
(470) 303-8019
(404) 393-7322
Mailing address
933 MAPLE ST, KINGSPORT, TN 37660-5219
(470) 303-8019
(404) 393-7322
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-5052742
NON-EMERGENCY TRANSPORTATION
TN
Enumeration date
05/03/2018
Last updated
06/16/2018
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