| NPI | 1134320468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA L BARTON Owner 731-285-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TN 38546) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |