| NPI | 1497421101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL INIMBOM SAMUEL Co Owner 865-765-8224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2021-08-22 |
| Last Update Date | 2021-08-22 |