| NPI | 1023266509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI RIDDLE Family Nurse Practitioner 731-234-3618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 11216) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2008-09-08 |