Provider Information for 1386391126
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TYNESHA PALMER
Sex: Female
NPI: 1386391126
Last Updated: 2024-02-08
Certification Date: 2024-02-08
Certification Date: 2024-02-08
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1386391126 | ||||||||||||||
| Enumeration Date | 2022-03-02 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 4160 OCOEE ST N STE 8 CLEVELAND, TN 37312-4886 United States Phone: 423-244-4050 | Fax: | ||||||||||||||
| Primary Practice Address | 4160 OCOEE ST N STE 8 CLEVELAND, TN 37312-4886 United States Phone: 423-464-4357 | Fax:423-464-4364 | ||||||||||||||
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