| NPI | 1083365670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCEL SIMO CEO/Owner 423-489-3575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-04-20 |