Healthcare Provider Details

I. General information

NPI: 1447558606
Provider Name (Legal Business Name): TRAWHS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 WOLF TRAIL CV
GERMANTOWN TN
38138-1753
US

IV. Provider business mailing address

7800 WOLF TRAIL CV
GERMANTOWN TN
38138-1753
US

V. Phone/Fax

Practice location:
  • Phone: 901-682-9222
  • Fax:
Mailing address:
  • Phone: 901-682-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS STOVAL
Title or Position: PRESIDENT
Credential: MD
Phone: 901-682-9222