| NPI | 1598834087 |
|---|---|
| Doing Business As | LAKE COUNTY INTERNAL MEDICINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | DANIEL P GREEN Owner Director 731-285-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 5993) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |