| NPI | 1891039244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE D MARKS Billing Manager 931-808-1244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2012-11-23 |
| Last Update Date | 2013-09-27 |