| NPI | 1356936595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW RAY HITCHCOCK Owner 423-763-1942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QP2000X Clinic/Center Physical Therapy | |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2024-07-26 |