| NPI | 1861446858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E RICKARD Owner 731-989-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: TN 44-3960) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2010-05-27 |