| NPI | 1639666399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY MCSWAIN Credentialing Specialist 865-243-8183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2023-10-12 |