| NPI | 1578804142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY DUCKETT Vice President 901-227-4068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 24112) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17737) |
| 363A00000X Physician Assistant (Licence: TN 1314) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 17471) | |
| 225100000X Physical Therapist (Licence: TN 05911) | |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-08-21 |