| NPI | 1417656869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Sr Director, Provider Enrollment 615-465-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2023-02-24 |
| Last Update Date | 2023-02-24 |