| NPI | 1093932766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE YVONNE GEETER Monitor 901-949-1889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: TN 101YM0800X) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |