| NPI | 1942317672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA S STUFFLESTREET Adminstrator 423-929-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TN 178) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2009-06-16 |