| NPI | 1508081373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARY MICHAUD Administrator 423-622-6615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TN PSS0000000026) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |