Organization
CUSTOMIZED MEDICAL NEEDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTI ALEXANDER-DAVIDSON (EXECUTIVE DIRECTOR)
(866) 563-7772
Entity
Organization
Contact information
Practice address
8295 TOURNAMENT DR, STE 2, MEMPHIS, TN 38125-8906
(866) 563-7772
(901) 255-0758
Mailing address
8295 TOURNAMEMT DR, STE 150, MEMPHIS, TN 38125-8900
(866) 563-7772
(901) 255-0758
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
6151932
TN
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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