| NPI | 1972364594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY ELIZABETH WELCH Fnp Bc/Owner 865-216-6424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |