| NPI | 1518508993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE ELIZABETH LYONS Credentialing Specialist 423-282-9011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2024-06-26 |