| NPI | 1831948504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MASSENGILL Director Of Operations 865-483-3904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QD0000X Clinic/Center, Dental | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-05-15 |