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General NPI Number Information
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NPI Number | 1033758792
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Entity Type | Individual
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Provider Name | AMY E GALYEN
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Gender | Female
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Dates
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Enumeration Date | 12/29/2019
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 5565 MURRAY AVE STE 101
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City | MEMPHIS
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State | TN
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Zip | 38119-3828
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Country | US
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Telephone | 901-767-8152
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Fax |
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Provider Business Mailing Address
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Address Line | 7593 BLACKBERRY FARM RD
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City | GERMANTOWN
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State | TN
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Zip | 38138-2107
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Country | US
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Telephone | 901-308-0359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2060
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License Number State | TN
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