| NPI | 1508824749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA LYNN CHIN Office Manager 423-728-1845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN MD31732) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA753) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-06-05 |