Individual
MICAH VAILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
675 S JEFFERSON AVE STE C, COOKEVILLE, TN 38501-0949
(931) 528-8822
Mailing address
675 S JEFFERSON AVE STE C, COOKEVILLE, TN 38501-0949
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13786
TN
Other
Enumeration date
11/21/2022
Last updated
05/17/2023
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