Organization
FINER THINGS FOR HER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY GLENN WILSON LIVELY (OWNER)
(423) 343-9043
Entity
Organization
Contact information
Practice address
1880 N EASTMAN RD, SUITE 230, KINGSPORT, TN 37664-2312
(423) 343-9043
(423) 343-9042
Mailing address
1880 N EASTMAN RD, SUITE 230, KINGSPORT, TN 37664-2312
(423) 343-9043
(423) 343-9042
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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