| NPI | 1962767400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE N QUISENBERRY Owner, Nurse Practitioner 270-825-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2016-08-15 |