| NPI | 1437449170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL D RADICAN President 901-682-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: TN MD430532) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TN DC1171) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2013-05-31 |