| NPI | 1386017390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYOSHA JOHNSON Owner 901-462-1775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TN 115005378) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2015-11-12 |