| NPI | 1962715524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LYTLE TERHUNE Medical Doctor 901-685-8202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 5464) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2010-07-23 |