| NPI | 1437524683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT WAYNE GARDNER Owner 423-551-8346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2016-04-14 |