| NPI | 1437389731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY R. BICKFORD Owner 865-247-6340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000012264) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2012-01-27 |