Healthcare Provider Details

I. General information

NPI: 1043972615
Provider Name (Legal Business Name): TAP TO TREAT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3286 N PARK BLVD STE G
ALCOA TN
37701-3275
US

IV. Provider business mailing address

PO BOX 10151
KNOXVILLE TN
37939-0151
US

V. Phone/Fax

Practice location:
  • Phone: 865-888-7890
  • Fax: 865-205-1092
Mailing address:
  • Phone: 865-888-7890
  • Fax: 865-205-1092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GRANT DAVIS
Title or Position: COO
Credential:
Phone: 865-888-7890