| NPI | 1245414291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY WAYNE CLARK Dr/Owner 615-661-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO0000000785) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2008-05-01 |