| NPI | 1356832364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY A HENEGAR Billing And Crendentialing 423-341-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: TN 17808) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |