| NPI | 1093118085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROLL E COMBS Credentialing Coordinator 615-435-0584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2015-10-16 |