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1629245634
BENITA K QUALLS
LEBANON, TN
NPI
1629245634
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Former Name
BENITA K ROBERTS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TN 185)
Enumeration Date
2008-05-09
Last Update Date
2011-08-09
Business Address
MRS. BENITA K QUALLS P.A.
1407 W BADDOUR PKWY
LEBANON, TN 37087-2513
Phone number: 615-444-6203
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Mailing Address
MRS. BENITA K QUALLS P.A.
1407 W BADDOUR PKWY
LEBANON, TN 37087-2513
Phone number: 615-444-6203
Copy
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