| NPI | 1053351593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDAL L DABBS President 865-604-3115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-09-10 |