| NPI | 1912178112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY F LANE Practice Administrator 423-245-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TN 25312) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |