| NPI | 1710288980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB VICTOR MESECK Authorized Official 615-266-2213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TN 2308) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: TN 2322) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2025-09-10 |