NPI | 1962753277 |
---|---|
Doing Business As | CROSSROADS FAMILY MEDICINE OF MT VERNON |
Entity Type | Organization |
Authorized Contact | TARA P RICHARDSON Authorized Offical 615-221-3672 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: IL 0003947) |
Enumeration Date | 2012-09-26 |
Last Update Date | 2016-04-25 |