| NPI | 1033516109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA CHARLENE JOHNSON Co Owner 901-345-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TN MD37230) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |