Healthcare Provider Details

I. General information

NPI: 1770075582
Provider Name (Legal Business Name): EN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 GUNBARREL RD STE 110
CHATTANOOGA TN
37421-4983
US

IV. Provider business mailing address

715 MARKET ST STE 203
CHATTANOOGA TN
37402-1837
US

V. Phone/Fax

Practice location:
  • Phone: 423-541-5102
  • Fax:
Mailing address:
  • Phone: 423-531-1330
  • Fax: 423-654-8052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD PHILLIPS
Title or Position: MANAGER
Credential:
Phone: 423-531-1330