NPI | 1053381236 |
---|---|
Entity Type | Organization |
Authorized Contact | SHERRYE B CRONE Administrator 901-516-1716 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 0000000084) |
Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 084) |
Enumeration Date | 2006-01-23 |
Last Update Date | 2012-02-01 |