| NPI | 1861905234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY S HAYES Owner 423-805-3832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 1646) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2020-05-07 |