| NPI | 1891884292 |
|---|---|
| Other Name | THE ID GROUP, PLLC |
| Entity Type | Organization |
| Authorized Contact | SHAUNA WOOTEN Medical Billing Administrator 423-648-9915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-12-15 |