| NPI | 1376943878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA KESTERSON Insurance 865-687-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN MD17837) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2014-09-03 |