| NPI | 1710164041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA CRUMP Member 423-614-0297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 812) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2011-06-29 |