Organization
PS MARYLAND IOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN MCCOLLUM (PRESIDENT & CEO)
(877) 396-3161
Entity
Organization
Contact information
Practice address
700 12TH AVE S, SUITE 306, NASHVILLE, TN 37203-3367
(877) 977-4630
(615) 457-1447
Mailing address
PO BOX 680835, FRANKLIN, TN 37068-0835
(877) 396-3161
(615) 457-1447
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2014
Last updated
09/10/2015
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