| NPI | 1467119032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYCE JOSLIN Authorized Official /Owner 423-368-4032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2022-07-19 |