| NPI | 1336615525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN A HOLBROOK Credentialing Specialist 423-217-0604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2018-10-16 |