| NPI | 1033102397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAROLYN M MOBLEY Administrator 731-644-2150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 0000000118) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2011-01-28 |