| NPI | 1790064954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS MANIS Manager 615-804-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2013-03-18 |