| NPI | 1912048307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL GIBSON President 615-449-5771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TN 41991) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2009-06-08 |