Individual
ETHIOPIA WORKU GEZAHAGN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2221 BEACHFRONT AVE, ANTIOCH, TN 37013-7425
(615) 424-4507
Mailing address
1413 RAVENNA CT N, ANTIOCH, TN 37013-1091
(615) 424-4507
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
201703240028964
TN
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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