| NPI | 1063946796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDA GARDNER FULLER Executive Director 615-732-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 000830915) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |