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1336827740
CARRIE B ILLUM
JOHNSON CITY, TN
NPI
1336827740
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-07-06
Last Update Date
2023-07-06
Business Address
CARRIE B ILLUM
917 W WALNUT ST
JOHNSON CITY, TN 37604-6527
Phone number: 423-439-6464
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Mailing Address
CARRIE B ILLUM
158 SPIDER BARNES RD
JONESBOROUGH, TN 37659-6333
Phone number: 970-988-7100
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