| NPI | 1780112805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANT KERSEY Medical Director 865-660-6634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TN 36477) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2017-06-02 |