| NPI | 1194978148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDIE JAMES BENNETT Physician/Owner 865-688-8999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD 26895) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2009-08-06 |