NPI | 1114117298 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENESHA L MOYE Director Of Services/Owner 615-485-9536 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: TN 01045184A) |
Enumeration Date | 2007-07-26 |
Last Update Date | 2007-11-14 |