| NPI | 1215504816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEAH MICHELLE SMITH Credentialing Manager 901-205-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2023-11-13 |