| NPI | 1285660613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA WILSON Owner 423-894-6418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TN 0000000477) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TN 0000000477) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: TN 0000000477) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-08-22 |