| NPI | 1891984712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLL E NOONAN Owner 865-971-6877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TN 34863) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |