| NPI | 1801391719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE E CLARK Family Nurse Pracititioner 901-500-5766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2018-03-24 |