Prodigal Primary Care Pc Valid NPI

Organization · Medical Physician Assistant · Knoxville, TN

NPI

1861704371

Type

Organization (Type 2)

Primary specialty

Medical Physician Assistant (Physician Assistant)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363AM0700X

License number

1506 (TN)

Enumerated

2010-07-13

Last updated

2013-08-21