| NPI | 1871954628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE L SITES Executive Director 423-246-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TN 268602) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-03-08 |