| NPI | 1528184744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PORTERA Owner 423-622-2494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |