Individual
GEKECIAL MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6158 GRAY OAK AVE, MEMPHIS, TN 38115-2710
(901) 859-5083
Mailing address
6158 GRAY OAK AVE, MEMPHIS, TN 38115-2710
(901) 859-5083
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
332BN1400X
TN
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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