| NPI | 1134673437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILABEN BHAGUBHAI PATEL Medical Director 615-721-5141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: TN 40426) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2016-08-04 |