| NPI | 1467959767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN KEITH Manager/Owner 865-236-0863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: SC 8497) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2020-08-17 |