| NPI | 1770524878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMENIC M. CANONICO Owner 931-684-3504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 0000000128) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2013-08-20 |