Individual
MR. LAITH ABDALFATTAH ABUOMRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
514 JEFFREY LN, COLLIERVILLE, TN 38017-1434
(540) 656-1393
Mailing address
514 JEFFREY LN, COLLIERVILLE, TN 38017-1434
(540) 656-1393
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
TXD718
TN
347C00000X
Private Vehicle
100037766
VA
Other
Enumeration date
09/19/2019
Last updated
04/03/2025
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