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 |