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 |