NPI | 1770291189 |
---|---|
Other Name | LEA BRAINERD, PA-C |
Entity Type | Organization |
Authorized Contact | LEA HAYLEY BRAINERD CEO 901-612-1486 |
Organization Subpart ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2022-11-14 |
Last Update Date | 2024-09-18 |