| NPI | 1639679962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYDNI CLEMMONS Credentialing Manager 931-981-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2024-03-14 |