Individual
TEQUA MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6309 ALTHORP CV, LAKELAND, TN 38002-7005
(901) 487-9653
(901) 829-7766
Mailing address
6309 ALTHORP CV, LAKELAND, TN 38002-7005
(901) 487-9653
(901) 829-7766
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
091404354
TN
Other
Enumeration date
04/08/2012
Last updated
03/02/2022
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