Organization
HIDEAWAY HEALTH TABLE LLC
Active
Other names
Hideaway Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY GILLILAND PTA (OWNER)
(256) 426-3593
Entity
Organization
Contact information
Practice address
4817 BROWNSTON CT SE, OWENS CROSS ROADS, AL 35763-9161
(256) 426-3593
Mailing address
4817 BROWNSTON CT SE, OWENS CROSS ROADS, AL 35763-9161
(256) 426-3593
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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