| NPI | 1205356813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARISSA LEE KRISHNAN Owner / Practice Manager 931-619-3243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2018-01-23 |