| NPI | 1699922401 |
|---|---|
| Other Name | MOBILE VAN SERVICE |
| Entity Type | Organization |
| Authorized Contact | TRACY MCDANIEL CEO 901-842-3160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2024-12-06 |