| NPI | 1023445475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY RUSSELL Manager 423-238-7217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |