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1316509334
JAMES CLARK CHILDRESS
SPARTA, TN
NPI
1316509334
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner Primary Care
(Licence: TN 26091)
Enumeration Date
2019-06-29
Last Update Date
2019-06-29
Business Address
JAMES CLARK CHILDRESS
457 VISTA DR
SPARTA, TN 38583-1360
Phone number: 931-738-3383
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Mailing Address
JAMES CLARK CHILDRESS
1609 FARMINGTON DR
COOKEVILLE, TN 38501-0743
Phone number: 931-644-2463
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