Healthcare Provider Details

I. General information

NPI: 1043616253
Provider Name (Legal Business Name): ENSIGHT HEALTH AND FITNESS CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2014
Last Update Date: 11/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6421 CADBURY DR
KNOXVILLE TN
37921-4907
US

IV. Provider business mailing address

6421 CADBURY DR
KNOXVILLE TN
37921-4907
US

V. Phone/Fax

Practice location:
  • Phone: 865-360-5359
  • Fax:
Mailing address:
  • Phone: 865-360-5393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number00158970
License Number StateTN

VIII. Authorized Official

Name: MR. LARRY LEE SAWYER JR.
Title or Position: OWNER
Credential:
Phone: 865-360-5393