NPI | 1154924785 |
---|---|
Doing Business As | AGELESS MEN'S HEALTH |
Entity Type | Organization |
Authorized Contact | TEAH MICHELLE SMITH Credentialing Manager 901-205-3999 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
Enumeration Date | 2020-11-17 |
Last Update Date | 2023-11-13 |