| NPI | 1629108691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARD K MAZZA Owner Md 423-476-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD015727) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000000148) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |