Individual
ESAM IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2021 N.HIGHLAND AVE, JACKSON, TN 38305
(615) 506-9028
Mailing address
2021 N HIGHLAND AVE # 12, JACKSON, TN 38305-4918
(615) 506-9028
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
2016 84394
TN
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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