Detraves Thicklin, ATC

NPI 1184167686 · on the registry since 2016

Practice

Address: 210 Walmart Dr
Ste 100
Soddy Daisy, TN 37379
Phone: (423) 332-9490
Fax: (423) 332-3817
Organisation at this address: Benchmark Healthcare Services Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 14

Registry record

Primary taxonomy: Athletic Trainer
2255A2300X
Licence states on file: TN
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2016-12-01

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