| NPI | 1912285057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA A BERRY-ARMOUR Credentialing Manager 423-317-9344 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2012-03-15 |