| NPI | 1205167509 |
|---|---|
| Doing Business As | FOOTHILLS PAIN MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | TERRY BRAGG President 865-982-7802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 0682) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 000011720) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 0000013567) | |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2010-01-26 |