| NPI | 1700377710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY A HENEGAR Billing And Credentialing 423-341-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: TN 16843) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2020-04-08 |