NPI | 1033893920 |
---|---|
Entity Type | Organization |
Authorized Contact | SYDNI CLEMMONS Director Of Credentialing 901-351-1791 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
Enumeration Date | 2023-06-12 |
Last Update Date | 2023-06-13 |