| NPI | 1164557856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SL LAMPKIN Owner 615-254-1786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TN md13877) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2022-08-03 |