| NPI | 1720719172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAILEE BOYETT Credentialing Specialist 615-678-0024 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2022-06-17 |