| NPI | 1528719614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDIE MANLEY Nurse Practitioner 931-302-9564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-01-11 |