| NPI | 1003529280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA ALDERSON Practice Manager 423-290-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-01-17 |