| NPI | 1013310762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN STASNEY Owner 865-531-6454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 24689) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 37682) |
| 363A00000X Physician Assistant (Licence: TN 2302) | |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2014-10-08 |