| NPI | 1356314454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAX BRADY STANDEFER Owner 423-877-3568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TN 0000000512) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2017-05-09 |