| NPI | 1154391340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRYE B CRONE Administrator 901-516-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 0000000096) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 096) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2012-02-01 |