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1497017578
LEO TAGBAR SUMATRA
MOUNT JULIET, TN
NPI
1497017578
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2251G0304X Physical Therapist Geriatrics
(Licence: TN PT1965)
Enumeration Date
2012-06-13
Last Update Date
2012-06-13
Business Address
MR. LEO TAGBAR SUMATRA
13135 LEBANON RD
MOUNT JULIET, TN 37122-2873
Phone number: 615-554-9224
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Mailing Address
MR. LEO TAGBAR SUMATRA
13135 LEBANON RD
MOUNT JULIET, TN 37122-2873
Phone number: 615-554-9224
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