| NPI | 1922377019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH WELLMAN Administrator 423-775-0771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT000008620) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TN OT000004463) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2017-03-15 |