| NPI | 1760279301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER TERWILLIGER Senior Credentialing Specialist 615-656-2750 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-04-24 |