| 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 |