| NPI | 1497226682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANCE BALLARD WILBOURN Owner/ Authorised Official 901-440-8482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2025-10-27 |