| NPI | 1386260792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE N MOORE-RHODES Owner 731-989-2829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2020-10-27 |