Individual
MRS. DENESE MICHELLE GOOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
623 CHESHIER ST, HALLS, TN 38040-1101
(731) 836-0052
Mailing address
623 CHESHIER ST, HALLS, TN 38040-1101
(731) 836-0052
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0000065629
TN
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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