| NPI | 1750792958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BENETTO Manager Of Payor & Prov Enrollment 423-238-8923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2020-02-12 |