| NPI | 1821452087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAROL MACLIN Provider/Co Owner 901-417-1779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 15453) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-27 |