| NPI | 1518196393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCHRICE DAVIS Fnp 901-461-7634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education (Licence: TN 109003480) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: TN 109003480) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2009-07-14 |