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1316322159
ESAM IBRAHIM
JACKSON, TN
NPI
1316322159
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
343900000X Non-emergency Medical Transport (VAN)
(Licence: TN 2016 84394)
Enumeration Date
2015-07-22
Last Update Date
2015-07-22
Business Address
-- ESAM IBRAHIM
2021 N.HIGHLAND AVE
JACKSON, TN 38305
Phone number: 615-506-9028
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Mailing Address
-- ESAM IBRAHIM
2021 N HIGHLAND AVE # 12
JACKSON, TN 38305-4918
Phone number: 615-506-9028
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