| NPI | 1215469358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINTON W CARROLL Owner 423-384-0614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 14954) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |