| NPI | 1720118086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA DEGUIRA Office Manager 865-483-1093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: TN MD 29931) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |