| NPI | 1770139974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY CHAVEZ Admin 865-927-6372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 208100000X Physical Medicine & Rehabilitation | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2019-08-13 |