| NPI | 1912419227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA GARRISON Credentialing Coordinator 865-584-2127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA 202072) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2019-01-31 |