| NPI | 1013163690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA HAZARD CREECH Member 731-983-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN MD024799) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2014-11-26 |