| NPI | 1104958487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL L. HEITHOLD Owner 423-362-4554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 43386) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2014-10-23 |