NPI | 1508310012 |
---|---|
Entity Type | Organization |
Authorized Contact | CANDACE WHITLEY Owner/Provider 615-306-8849 |
Organization Subpart ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 1195) |
Enumeration Date | 2016-08-12 |
Last Update Date | 2016-08-12 |