Search › Tennessee › 364SH0200X
Ian Mall
NPI 1144689456 · on the registry since 2016 · sole proprietor
Practice
- Address
- 9981 Forrest Dr
Ooltewah, TN 37363 - Phone
- (423) 362-8192
Registry record
- Primary taxonomy
- 364SH0200X
364SH0200X
- Licence states on file
- TN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-02-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee