NPI | 1861664898 |
---|---|
Entity Type | Organization |
Authorized Contact | RODERICK VINCENT FRAZIER Owner 615-851-1777 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TN DS005013) |
Enumeration Date | 2008-03-31 |
Last Update Date | 2008-03-31 |