NPI | 1366636839 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVIN H STROUP Physician 731-307-8095 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000023810) |
Enumeration Date | 2007-08-28 |
Last Update Date | 2007-08-28 |