| NPI | 1306836606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE DELAINE JONES Administrator 423-472-7874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 0000000002) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-08-22 |