| NPI | 1548515638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KATHERYN GOODWIN Nurse Practitioner/Owner 731-798-0868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 13401) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2012-07-16 |