| 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 |