| NPI | 1043448632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD NOLAN HATHCOCK Owner 901-767-8077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: TN 1858) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2009-06-23 |