| NPI | 1770817322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WASHINGTON KEN President 615-372-5170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K6565) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX K6565) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2013-07-01 |