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1285289249
MICAH MCCOLLOCH
COOKEVILLE, TN
NPI
1285289249
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TN 7124)
Enumeration Date
2019-08-07
Last Update Date
2019-08-07
Business Address
MICAH MCCOLLOCH PTA
815 S WALNUT AVE
COOKEVILLE, TN 38501-5956
Phone number: 931-528-5516
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Mailing Address
MICAH MCCOLLOCH PTA
2539 SPARKMANTOWN RD
DOYLE, TN 38559-3235
Phone number: 931-607-4885
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