| NPI | 1659740702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY ACKAOUY Office Manager 423-745-5955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 20337) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |