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Organization
GENERATED FAMILY MEDICAL RESOLUTION
Active
Organization
GENERATED FAMILY MEDICAL RESOLUTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN RANDALL CANNON MBA (CEO/ADMINISTRATOR)
(931) 993-3573
Entity
Organization
Contact information
Practice address
3085 COMMONWEALTH DR, 2332, SPRING HILL, TN 37174
(931) 993-3573
(931) 674-2259
Mailing address
3085 COMMONWEALTH DR APT 2332, SPRING HILL, TN 37174-3137
(931) 993-3573
(931) 674-2259
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
TN
Other
Enumeration date
07/07/2017
Last updated
07/21/2022
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