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Vienna Cornell

NPI Registration Record

Provider / OrganizationNPIDate Certified
VIENNA CORNELL13569596962020-07-24
Entity TypeIndividual
Provider Name Vienna Cornell
Other Provider Name Vienna Eun Pae
Practice Office Address6110 SHALLOWFORD RD
CHATTANOOGA, TN US
Practice Office Telephone4234991031
Mailing Address6110 SHALLOWFORD RD
CHATTANOOGA, TN 374211894 US
HPT Codes
CodeLicense NoState
101YP2500X PRIMARY
OPI Codes

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