| NPI | 1003021858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY A HOWARD Billing 931-728-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: TN MD16760) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2011-05-19 |