| NPI | 1114255817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MATTHEW TALLMAN C.E.O./ Practitioner 931-380-0677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN APN0000014483) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |