| NPI | 1578369609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA NEAL Manager, Credentialing 615-300-7871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-20 |