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1164059093
DIERDRE LOUISE CHARLETT
KINGSTON, TN
NPI
1164059093
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2251P0200X Physical Therapist, Pediatrics
(Licence: TN 12758)
Enumeration Date
2020-03-23
Last Update Date
2020-03-23
Business Address
DIERDRE LOUISE CHARLETT
187 GALLAHER RD
KINGSTON, TN 37763-4721
Phone number: 865-376-4620
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Mailing Address
DIERDRE LOUISE CHARLETT
PO BOX 4847
OAK RIDGE, TN 37831-4847
Phone number:
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