| NPI | 1144465279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANA SHARON BEAVERS Single Member LLC 931-684-8469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000008506) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |