| NPI | 1457634180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHREAREST MIGNON CRENSHAW Physician 901-684-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 39250) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-09-20 |