| NPI | 1942626304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY RUSSELL Manager Of Provider And Payer Enrol 423-238-8923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2014-03-10 |