Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ORT0000000180 | TN |
N | 222Z00000X | Podiatrist | ORT0000000180 | TN |
Y | 224P00000X | Prosthetist | PRO0000000084 | TN |
NPI | 1124248885 |
---|---|
Provider Name | Mr. Tien Tran |
First Address | Cordova, TN 38018-3110 |
Second Address | Cordova, TN 38018-3110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 06/05/2009 |