| NPI | 1437122785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA HALFORD Business Office Mgr. 731-886-1240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 7070) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN RN0000036124) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2016-03-03 |