| NPI | 1346759636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAVER T SHATTUCK Chief Medical Officer 865-770-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 3550) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 27892) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 21354) | |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |