| NPI | 1710619143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH RYAN SHAW Doctor/Owner 615-447-5220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2022-06-24 |