| NPI | 1992175582 | 
|---|---|
| Doing Business As | PHOENIX PRACTICE MANAGEMENT | 
| Entity Type | Organization | 
| Authorized Contact | REGAN WILSON Owner 404-492-8830 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies | 
| Enumeration Date | 2015-09-25 | 
| Last Update Date | 2015-09-25 |