| NPI | 1104640564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA L IVORY FULLER President 901-643-3556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 133V00000X Dietitian, Registered | |
| 171400000X Health & Wellness Coach | |
| 207RN0300X Internal Medicine, Nephrology | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-11-12 |
| Last Update Date | 2024-11-12 |