| NPI | 1861190779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI WIDDIFIELD Practice Administrator 423-339-9581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2024-03-22 |