| NPI | 1295044097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN GENTRY COO 931-540-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2010-09-28 |