NPI | 1598063828 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD D SHEPPARD Supervising Physician 276-679-0800 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
Enumeration Date | 2011-03-10 |
Last Update Date | 2011-03-10 |