NPI | 1801834221 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDY GRAY Credentialing 423-442-2622 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2006-06-04 |
Last Update Date | 2011-02-25 |