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1679568968
TIMOTHY E VIVIAN
COOKEVILLE, TN
NPI
1679568968
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: TN P0770)
Enumeration Date
2005-09-13
Last Update Date
2012-06-20
Business Address
Mr. TIMOTHY E VIVIAN PA
675 SOUTH JEFFERSON AVE
COOKEVILLE, TN 38501-0949
Phone number: 931-520-0148
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Mailing Address
Mr. TIMOTHY E VIVIAN PA
675 SOUTH JEFFERSON AVE
COOKEVILLE, TN 38501-0949
Phone number: 931-520-0148
Copy
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