| NPI | 1073755575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JOEL MOORE President 423-775-6688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: TN DC0000002218) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2009-03-30 |