| NPI | 1073703591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY I WILBON Nurse Practioner 901-728-5858 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: TN 10556) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2007-07-31 |