| NPI | 1730492166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL WILSON Phamacist 901-201-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TN 12154) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2010-07-14 |