Organization
TIFFANY R SMITH
Active
Other names
TRS Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY R SMITH (CRANIAL PROSTHESIS)
(901) 254-2278
Entity
Organization
Contact information
Practice address
823 EXOCET DR, CORDOVA, TN 38018-2270
(901) 254-2278
Mailing address
469 J E CLARK CV, MARION, AR 72364-2308
(901) 254-2278
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
179792
TN
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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