| NPI | 1477812196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY A HUMPHREY Provider Relations/Compliance Offic 865-691-9055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 225100000X Physical Therapist | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2022-04-13 |