| NPI | 1255719688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL DAVID BANICK Owner/Cmo 865-342-7859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 29453) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2015-05-18 |