| NPI | 1043228646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY L FALCONER Administrator 423-230-6352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD0000018839) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |