| NPI | 1396022463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY NATHAN LAURENCE Owner 901-752-4999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000025017) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |