| NPI | 1669861373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS BRANDON FORRESTER President 423-479-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 225100000X Physical Therapist | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-01-19 |