| NPI | 1336135607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director Of Provider Enrollment 615-465-7626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2021-09-13 |