| NPI | 1427831759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MELISSA TIBEDO National Pe Director 865-985-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services |
| 363AM0700X Physician Assistant Medical | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2024-05-30 |