| NPI | 1215288246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVETTE WALLACE Director Of Contract Management 423-238-7217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |