| NPI | 1114027224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENA L DEWEESE Office Manager 865-548-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN PA0000000971) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2017-03-09 |