NPI | 1205005097 |
---|---|
Entity Type | Organization |
Authorized Contact | SALLIE EARLY TUCKER Owner 865-558-1584 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN APN0000007667) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN APN0000007667) |
Enumeration Date | 2008-02-26 |
Last Update Date | 2008-02-26 |