NPI | 1598538571 |
---|---|
Former Legal Business Name | NONE |
Entity Type | Organization |
Authorized Contact | KRISTIE PEGGINS Nurse Practitioner/Owner 901-601-0266 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Enumeration Date | 2023-11-01 |
Last Update Date | 2023-11-01 |