| NPI | 1952472185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DAWN DIGIAMMARINO Practice Manager 423-472-6548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO256) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-08-22 |