| NPI | 1295930089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA DYCUS Practice Manager 931-728-0772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN APN6245) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TN APN5896) |
| 261QP2300X Clinic/Center, Primary Care (Licence: TN DO1634) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2008-03-05 |