| NPI | 1518650001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAY STALCUP Co Owner 865-406-2715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2023-05-31 |