| NPI | 1356486252 |
|---|---|
| Doing Business As | MANTLE CLINIC III |
| Entity Type | Organization |
| Authorized Contact | JAMES GREGORY ROBERTS Physician 865-218-6244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN 37706) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-05-21 |