| NPI | 1508969528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDIE JAMES BENNETT Medical Director/Physician 865-219-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2008-04-17 |