| NPI | 1093435190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BENETTO Director Of Payor Enrollment 423-339-7350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-08-30 |