| NPI | 1891834198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE GARDINER Administrator 615-331-1473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-11 |