| NPI | 1073807061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINNIE REED TRAYLOR Md 901-550-0229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TN md11058) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |