| NPI | 1861721524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA L COLLIS Office Manager 731-668-4337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology (Licence: TN 12441) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2009-12-28 |