| NPI | 1194279505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELORIS B ALLEN Owner 901-337-4554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 5858) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2017-01-13 |