| NPI | 1376330696 |
|---|---|
| Doing Business As | FALLEN LEAF MEDICAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL RADFORD MOORE Owner 865-549-0750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2025-04-21 |