Healthcare Provider Details

I. General information

NPI: 1831825504
Provider Name (Legal Business Name): TOTAL RECOVERY MIND & BODY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5724 WESTERN AVE
KNOXVILLE TN
37921-2224
US

IV. Provider business mailing address

5724 WESTERN AVE
KNOXVILLE TN
37921-2224
US

V. Phone/Fax

Practice location:
  • Phone: 865-281-5480
  • Fax: 865-281-5484
Mailing address:
  • Phone: 865-281-5480
  • Fax: 865-281-5484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN SHREVE KAMAR
Title or Position: PRESIDENT
Credential:
Phone: 865-281-5480