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General NPI Number Information
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NPI Number | 1225125560
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Entity Type | Organization
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Legal Business Name | ENHANCED FITTINGS
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 611 CARTER AVE
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City | HARRIMAN
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State | TN
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Zip | 37748-2414
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Country | US
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Telephone | 865-882-8182
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Fax | 865-882-8182
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Provider Business Mailing Address
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Address Line | 611 CARTER AVE
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City | HARRIMAN
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State | TN
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Zip | 37748-2414
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Country | US
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Telephone | 865-882-8182
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Fax | 865-882-8182
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Authorized Official
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Title or Position | OWNER / CERTIFIED FITTER
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Name | REBA NELSON
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Credential |
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Telephone | 865-882-8182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | TN
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