| NPI | 1508903931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN REAGAN MOORE Sole Properitor 615-771-7718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD0000019800) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-12-08 |