NPI | 1710008628 |
---|---|
Entity Type | Organization |
Authorized Contact | JULIA BRATCHER State Director 901-384-3645 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: TN L3(20)4m3-056-6214) |
Enumeration Date | 2007-04-02 |
Last Update Date | 2020-08-22 |