| NPI | 1346963444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R KRAGEL Owner/Authorized Official 423-586-6263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2024-05-22 |