| NPI | 1528140894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY FAITH NORTHCUTT Owner 931-507-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: TN PA1401) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2009-03-13 |