| NPI | 1215272547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE D MARKS Billing Manager 931-526-7104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2013-02-20 |