| NPI | 1396713202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY WARREN Billing Office 731-285-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 0000000087) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2008-09-22 |