| NPI | 1659152320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BARRETT DEUBERT Owner 865-579-7606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2023-10-18 |