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1649898818
MARKEISHA LAQUITA WARDELL
CLARKSVILLE, TN
NPI
1649898818
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
335E00000X Prosthetic/Orthotic Supplier
(Licence: TN 0107051558)
Enumeration Date
2020-07-13
Last Update Date
2020-07-13
Business Address
MARKEISHA LAQUITA WARDELL
1502 TINY TOWN RD
CLARKSVILLE, TN 37042-8087
Phone number: 931-645-4270
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Mailing Address
MARKEISHA LAQUITA WARDELL
3684 AURORA DR
CLARKSVILLE, TN 37040-2553
Phone number: 931-591-8501
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