| NPI | 1942826144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MANN Credentialing Billing Manager 901-422-7608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2021-12-27 |