| NPI | 1356507404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY SHELLEY Office Manager/Assist. Business Adm 931-570-4755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2008-07-29 |