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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI Number | 1992966097 |
| LBN Legal business name | AMG-SOUTHERN TENNESSEE LLC |
| Authorized official | WILLIAM GRACEY - (COO) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 06/20/2008 |
| Last updated | 06/20/2008 - About 18 years ago |
| Identifiers | n/a |
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AMG-SOUTHERN TENNESSEE LLC