TRISTAN FAITH BROCK

LA FOLLETTE, TN
NPI1669716023
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: TN  1588)
Enumeration Date2012-11-23
Last Update Date2012-11-23
Business Address
-- TRISTAN FAITH BROCK COTA/L
136 DAVIS LN
LA FOLLETTE, TN 37766-3118
Phone number: 423-494-0550
Mailing Address
-- TRISTAN FAITH BROCK COTA/L
2705 PINECREST RD
JACKSBORO, TN 37757-3103
Phone number: 423-494-0550
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