| NPI | 1225220700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES SANDERFUR Owner/Therapist 865-584-6374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TN lpc0812) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2007-08-17 |