| NPI | 1275607129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEDD DEBONIS Practice Administrator 423-648-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 000026097) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TN P00000001508) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 046733) | |
| 363L00000X Nurse Practitioner (Licence: TN APN0000011670) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN0000006029) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN APN5515) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APRN10588) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN14069) | |
| 363A00000X Physician Assistant (Licence: TN PA1448) | |
| 207R00000X Internal Medicine (Licence: TN MD0000024920) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2016-03-15 |