| NPI | 1982456422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY POOLE Owner/Administrator 423-269-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-04-11 |