| NPI | 1700394863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARWAN MOUGHRABI Co Owner 423-870-1662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-01-11 |