| NPI | 1447629670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANA MICHELLE HANEY Physician Assistant 423-710-4771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TN PA0000001509) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2016-07-11 |