Organization
HANDICAP OF JACKSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TY JONES ATP (MANAGER)
(731) 660-6116
Entity
Organization
Contact information
Practice address
2088 HOLLYWOOD DR, JACKSON, TN 38305-4380
(731) 660-6116
(731) 660-6252
Mailing address
2088 HOLLYWOOD DR, JACKSON, TN 38305-4380
(731) 660-6116
(731) 660-6252
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
748
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455080
—
TN
01
—
4049264
BCBS TN
TN
Enumeration date
07/01/2005
Last updated
01/25/2023
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