Organization
EXTRA MILE HOMECARE SERVICES
Active
Other names
Visiting Angels
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH WYSONG (OWNER)
(731) 217-5944
Entity
Organization
Contact information
Practice address
1121 TROTWOOD AVE STE 2, COLUMBIA, TN 38401-1803
(931) 223-8083
Mailing address
1121 TROTWOOD AVE STE 2, COLUMBIA, TN 38401-1803
(931) 223-8083
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/04/2021
Last updated
06/04/2021
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