| NPI | 1780947978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY RUSSELL Manager 423-238-8923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-08-10 |