| NPI | 1245242817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD MICHAEL Physician/ Part Owner 901-367-9001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2011-11-30 |