NPI | 1104964576 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES ANDREW JORDAN Physician 615-453-1252 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
Enumeration Date | 2007-02-01 |
Last Update Date | 2025-03-16 |