| NPI | 1659670412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMER BREEDEN Business Manager 423-744-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: TN MD19704) |
| Enumeration Date | 2011-03-19 |
| Last Update Date | 2022-05-23 |