Provider Demographics
NPI:1548515760
Name:DAWS, CAROLYN JOY
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JOY
Last Name:DAWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTS HILL
Mailing Address - State:TN
Mailing Address - Zip Code:38374-5082
Mailing Address - Country:US
Mailing Address - Phone:731-549-4215
Mailing Address - Fax:731-549-2509
Practice Address - Street 1:5110 ROGERS RD
Practice Address - Street 2:
Practice Address - City:SCOTTS HILL
Practice Address - State:TN
Practice Address - Zip Code:38374-5082
Practice Address - Country:US
Practice Address - Phone:731-549-4215
Practice Address - Fax:731-549-2509
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-14
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN171WV0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WV0202XOther Service ProvidersContractorVehicle Modifications