| NPI | 1023252012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO S DICKENS Owner 423-710-1224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN DPM0000000690) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2010-08-18 |