| NPI | 1932899176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHON EDWARD LUCAS Co Owner/ Manager 423-444-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2024-01-31 |