NPI 1073984985

Ibrahim Azrag

Practitioner Driver Antioch, TN

Practice location

Address: 3120 Shady Tree Ln, Antioch, TN 37013-2482
Phone: (615) 585-3778
Fax: (206) 888-4011

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 189601 (TN)

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Registry record

NPI: 1073984985
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Oct 2015
Record last updated: 19 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.