| NPI | 1104061688 |
|---|---|
| Other Name | MARY BLACK MINOR CARE |
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director Provider Enrollment 615-465-7626 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2008-12-11 |