| NPI | 1275016941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER FILER Credentialing Manager 901-390-2930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2023-03-20 |