MEDICARE: PRIORITY ONE MEDICAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	227800000X	Certified Respiratory Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1902909252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIORITY ONE MEDICAL, INC.

Provider Business Mailing Address
First Line	:	8132 CORDOVA RD
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-6005
Country	:	US
Telephone Number	:	901-367-0811
Fax Number	:	901-367-9569

Provider Business Practice Location Address
First Line	:	8132 CORDOVA RD
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-6005
Country	:	US
Telephone Number	:	901-367-0811
Fax Number	:	901-367-9569

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL CORTES HOLLIMAN
Credential	:	D.C.
Telephone Number	:	901-367-0811

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	08/20/2007

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Directions to “PRIORITY ONE MEDICAL, INC. ” Practice Location

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