| NPI | 1467688390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE L ALLISON Practice Manager 865-588-1847 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TN 0000000171) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |