Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC 554 | TN |
NPI | 1124071360 |
---|---|
Provider Name | Dr. Rowen S. Pfeifer |
First Address | Brentwood, TN 37027-9103 |
Second Address | Brentwood, TN 37027-9107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 22/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T74640 | (02) | TN |