| NPI | 1073986410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB WALLSTEDT Chief Of Business Development 615-340-6840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2024-02-08 |