Organization
TYPE 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHEE GUSTAVE (OWNER)
(423) 834-6699
Entity
Organization
Contact information
Practice address
5793 BRAINERD RD, CHATTANOOGA, TN 37411-4011
(423) 834-6699
(423) 499-6408
Mailing address
5406 AUTUMN WOOD DR, CHATTANOOGA, TN 37416-1553
(423) 834-6699
(423) 344-1070
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
044113
TN
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
Update your record
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