| NPI | 1891242939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MECHELLE TAYLOR MORAGNE CEO, Owner 731-418-1656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TN 37286) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |