| NPI | 1619487782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MCCULLERS Authorized Official 901-866-8864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2020-04-24 |