| NPI | 1457622235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERIC DUNN CEO 901-213-8395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TN 0603997) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2012-01-25 |