| NPI | 1760803324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT H. O'DELL Secretary 865-558-3476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 00000456) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 7068360002) | |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2023-08-28 |