Healthcare Provider Details
I. General information
NPI: 1609389923
Provider Name (Legal Business Name): JAMES BERTRAM SOLOMON
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2017
Last Update Date: 11/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8029 RAY MEARS BLVD STE 300
KNOXVILLE TN
37919-2710
US
IV. Provider business mailing address
8029 RAY MEARS BLVD STE 300
KNOXVILLE TN
37919-2710
US
V. Phone/Fax
- Phone: 865-337-5574
- Fax: 865-313-2461
- Phone: 865-337-5574
- Fax: 865-313-2461
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 1800 |
| License Number State | TN |
VIII. Authorized Official
Name: MR.
JAMES
BERTRAM
SOLOMON
JR.
Title or Position: OWNER
Credential: DC
Phone: 865-337-5574