| NPI | 1124482864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS SHELLY VP & General Manager 615-425-4287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ AP8609) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2025-10-22 |