NPI | 1104830405 |
---|---|
Entity Type | Organization |
Authorized Contact | CAROLYN KISTNER FLETCHER-HELTON Practice Administrator 423-844-5412 |
Organization Subpart ? | No |
Primary Taxonomy | 207T00000X Neurological Surgery |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
332B00000X Durable Medical Equipment & Medical Supplies | |
363A00000X Physician Assistant | |
363LA2200X Nurse Practitioner, Adult Health | |
Enumeration Date | 2006-07-29 |
Last Update Date | 2022-02-01 |