| NPI | 1841403243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOUSA NASERI Owner 423-753-6077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TN APN6456) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2023-01-06 |