| NPI | 1679952576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE R TITTLE Owner 931-919-4894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 2233) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-28 |