| NPI | 1790064087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN SCOTT STOREY Executive Director 423-834-1419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN 1000000008331) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |