| NPI | 1487693123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MONTGOMERY Authorized Official 931-645-1373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 0000000095) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: TN 0000000095) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2025-09-22 |