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1124637905
CAROLINE GRACE DERRICK
BRISTOL, TN
NPI
1124637905
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2020-07-28
Last Update Date
2020-07-28
Business Address
CAROLINE GRACE DERRICK PA
271 MEDICAL PARK BLVD
BRISTOL, TN 37620-7455
Phone number: 423-274-8600
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Mailing Address
CAROLINE GRACE DERRICK PA
309 JACKSON RD
DICKSON, TN 37055-1419
Phone number: 615-477-0493
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