| NPI | 1912178468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINDY KAY STREET Office Manager 615-329-4001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD0000008875) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2008-03-12 |