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 |