| NPI | 1336997022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA PURDY President 931-674-1620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-05-08 |