| NPI | 1750386918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA B VAN ALSTINE Facility Administrator 901-527-6871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 000000079) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-08-22 |