| NPI | 1609906676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD DALE JAMES III Doctor 865-483-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN MD0000033918) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-05-30 |