| NPI | 1265165179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BENETTO Credentialing Director 423-238-8923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-07-07 |