| NPI | 1891995494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY STEPHEN WILEY Owner/Operator 931-728-0939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD16070) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |