Healthcare Provider Details

I. General information

NPI: 1861732562
Provider Name (Legal Business Name): APPLE MEDICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7446 SHALLOWFORD RD SUITE 101
CHATTANOOGA TN
37421-8815
US

IV. Provider business mailing address

7446 SHALLOWFORD RD SUITE 101
CHATTANOOGA TN
37421-8815
US

V. Phone/Fax

Practice location:
  • Phone: 423-855-7376
  • Fax: 423-855-8455
Mailing address:
  • Phone: 423-855-7376
  • Fax: 423-855-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPN16032
License Number StateTN

VIII. Authorized Official

Name: DR. NICHOLAS JOSEPH CIRCOLONE
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C., DACO
Phone: 423-855-7376