| NPI | 1407244171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN COLLIER Owner 731-664-7949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2023-05-22 |