| NPI | 1437373248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES S. HERTZ Director 731-426-0310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 0000000194) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2008-07-18 |