| NPI | 1043647142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES AUSTIN MITCHELL President/Owner 615-810-8730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN 37546) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2017-11-21 |