| NPI | 1639844954 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JAGRUTI RAJ Owner 423-933-5223 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Additional Taxonomies | 207R00000X Internal Medicine | 
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-08-09 | 
| Last Update Date | 2023-05-26 |