| NPI | 1770767790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA J. HOUSE Insurance, Credentialing 865-546-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD0000010436) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |