NPI | 1558569566 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREA S ABBOTT Owner 731-584-3181 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TN APN0000006876) |
Enumeration Date | 2007-07-11 |
Last Update Date | 2013-07-30 |