| NPI | 1205908506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY DAVID HINTON Co Owner 423-318-8824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN PRO0000000072) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: TN ORT0000000108) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: TN PED0000000060) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2019-12-19 |