NPI | 1669568499 |
---|---|
Doing Business As | SHANDS LIVE OAK MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | PAULA LALOR Director/Delegated Official 615-925-4565 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: FL 4314) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2018-02-23 |