| NPI | 1487747457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WAMACK Practice Owner 423-698-4899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN 590) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-04-07 |