| NPI | 1780837724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVELINO G REYES Owner 901-685-5231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TN MD16093) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2008-11-03 |