| NPI | 1003436932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN EILEEN MORRISON Owner 615-905-8083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-10-01 |