| NPI | 1619386877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY W YOUNG Fnp/Co Owner 731-300-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 7239) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2014-08-12 |