| NPI | 1215322425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE COOPER BARTON Nurse Practitioner 731-407-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 15828) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2023-03-07 |