| NPI | 1336815620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS LOGAN Authorized Official Owner 901-484-5157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2022-08-11 |