| NPI | 1386899300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN HESSELRODE Owner 901-737-4565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251S00000X (Licence: TN APN0000007462) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2021-09-28 |