MEDICARE: MARBLE CITY FAMILY CHIROPRACTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2790	TN

General Provider Information

NPI Number	:	1396113973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARBLE CITY FAMILY CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	7347 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-5714
Country	:	US
Telephone Number	:	865-766-2081
Fax Number	:

Provider Business Practice Location Address
First Line	:	7347 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-5714
Country	:	US
Telephone Number	:	865-766-2081
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. JASON BLOOM
Credential	:	D.C.
Telephone Number	:	865-766-2081

Provider Enumeration Date	:	09/12/2015
Last Update Date	:	12/09/2025

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