| NPI | 1336905561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON L AIUTO Credentialing Manager 865-314-8114 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2024-02-26 |