| NPI | 1881605509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN R MYNATT Owner 865-982-7540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: TN 012896) |
| Additional Taxonomies | 208800000X Urology (Licence: TN MC0000012896) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2010-08-09 |