LA WANNA WALLEN BROCK

TAZEWELL, TN
NPI1407932387
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: TN  APN6601)
Enumeration Date2006-10-31
Last Update Date2007-07-08
Business Address
-- LA WANNA WALLEN BROCK F.N.P., A.P.N.
1442 NORTH BROAD STREET SUITE 7
TAZEWELL, TN 37879
Phone number: 423-626-6145
Mailing Address
-- LA WANNA WALLEN BROCK F.N.P., A.P.N.
1037 OLD JACKSBORO RD
CUMBERLAND GAP, TN 37724-4444
Phone number: 423-626-6145
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