NPI | 1649471467 |
---|---|
Entity Type | Organization |
Authorized Contact | NATHAN LUCAS President 901-309-8898 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
Additional Taxonomies | 293D00000X Physiological Laboratory |
261QM1300X Clinic/Center Multi-Specialty | |
332B00000X Durable Medical Equipment & Medical Supplies | |
261QP2000X Clinic/Center Physical Therapy | |
261QP3300X Clinic/Center Pain | |
3336C0002X Pharmacy Clinic Pharmacy | |
Enumeration Date | 2007-05-30 |
Last Update Date | 2020-04-09 |