| NPI | 1811458565 |
|---|---|
| Doing Business As | CLINICA FAMILIAR LATINOAMERICA |
| Entity Type | Organization |
| Authorized Contact | RUDY GARY HAMM Provider 865-635-8389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-12-20 |