| NPI | 1497015168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STEVEN EDWARDS Physician 901-318-1946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TN MD14066) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2020-08-12 |