NPI | 1609900612 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY ALLEN SWETNAM President 731-286-0198 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TN 1991) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2020-08-22 |