| NPI | 1700213584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA RUSSELL Manager 615-333-2247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2014-01-28 |