Organization
INNOVATIVE SOLUTIONS LLC
Active
Other names
Foot Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE L KRUSE CPED (OWNER)
(615) 874-5656
Entity
Organization
Contact information
Practice address
4664 LEBANON PIKE, HERMITAGE, TN 37076-1314
(615) 874-5656
(615) 874-5651
Mailing address
4664 LEBANON PIKE, HERMITAGE, TN 37076-1314
(615) 874-5656
(615) 874-5651
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
332BC3200X
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4090756
BCBS PROVIDER ID
TN
Enumeration date
03/20/2007
Last updated
02/08/2012
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