| NPI | 1154953453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA YATES Billing Manager 865-888-4721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-07-22 |