| NPI | 1174596019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MATUKEWICZ Secretary 423-756-2268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 829) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2017-04-27 |