BRIAN BLAKE CHILDRESS

JACKSON, TN
NPI1740791847
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: TN  PA3467)
Enumeration Date2017-10-16
Last Update Date2017-12-12
Business Address
BRIAN BLAKE CHILDRESS PA
87 MURRAY GUARD DR STE B
JACKSON, TN 38305-3775
Phone number: 731-422-0213
Mailing Address
BRIAN BLAKE CHILDRESS PA
PO BOX 400
JACKSON, TN 38302-0400
Phone number: 731-422-0213
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