Organization
INDEPENDENT LIVING OF TENNESSEE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L SWAFFORD (OWNER)
(423) 710-3147
Entity
Organization
Contact information
Practice address
5512 RINGGOLD RD, SUITE 210, CHATTANOOGA, TN 37412-3183
(423) 710-3147
Mailing address
5512 RINGGOLD RD, SUITE 210, CHATTANOOGA, TN 37412-3183
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
00042731
TN
Other
Enumeration date
03/25/2010
Last updated
03/25/2010
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