| NPI | 1134504764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE R CORUM Provider/Owner 865-745-1799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TN 5712) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2022-12-29 |