| NPI | 1952597452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY T GRAY CFO & Treasurer 615-345-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA 3649) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2014-09-25 |