| NPI | 1871637892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA G WOOD R.N. Supervisor 731-968-8148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: TN 163WOOOOOX) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |