| NPI | 1477723245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN FOX President 865-796-9200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: NJ 25MA05473800) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2018-03-17 |