| NPI | 1013469725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE ZGIET CEO 865-444-2130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 16115) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2016-10-28 |