| NPI | 1376965210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY R LETCHWORTH Sole Owner 901-413-9426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 12181) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-10-16 |