Organization
BW SPORTS PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESLEY O. JAMES (CFO TENET)
(404) 265-5009
Entity
Organization
Contact information
Practice address
320 COOSA ST E, TALLADEGA, AL 35160-2276
(205) 877-2663
(205) 874-9622
Mailing address
PO BOX 742727, ATLANTA, GA 30374-2727
(205) 877-2663
(205) 874-9622
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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