Healthcare Provider Details

I. General information

NPI: 1841201910
Provider Name (Legal Business Name): BRYAN E. KNIGHT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 MAIN ST BOX 219
ALTAMONT TN
37301-3639
US

IV. Provider business mailing address

1595 MAIN ST PO BOX 219
ALTAMONT TN
37301-3639
US

V. Phone/Fax

Practice location:
  • Phone: 931-692-5500
  • Fax: 931-692-5501
Mailing address:
  • Phone: 931-692-5500
  • Fax: 931-692-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BRYAN EDWARD KNIGHT SR.
Title or Position: OWNER
Credential: FNP
Phone: 931-692-5500