| NPI | 1073095154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE CROWDER MATTHEWS Practitioner 423-720-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: TN 16835) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP2300X Clinic/Center Primary Care | |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2025-06-06 |