Provider Demographics
NPI:1679807887
Name:WORLD OF INDEPENDENCE DYNAMIC CONVERSIONS
Entity Type:Organization
Organization Name:WORLD OF INDEPENDENCE DYNAMIC CONVERSIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-932-2880
Mailing Address - Street 1:8742 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-4559
Mailing Address - Country:US
Mailing Address - Phone:865-932-2880
Mailing Address - Fax:
Practice Address - Street 1:8742 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-4559
Practice Address - Country:US
Practice Address - Phone:865-932-2880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies