| NPI | 1629200464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRIE B WATSON Fnp 731-407-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN APN12936) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2016-11-21 |