| NPI | 1447950670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Snr Director Provider Enrollment 615-465-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2023-03-07 |