| NPI | 1962467951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY MUSIC Director Of Provider Enrollment 615-465-7377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2024-08-12 |