| NPI | 1558783464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ZGIET Owner 865-771-0205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 16115) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: TN 16115) |
| Enumeration Date | 2014-01-11 |
| Last Update Date | 2014-06-16 |