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General NPI Number Information
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NPI Number | 1396113973
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Entity Type | Organization
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Legal Business Name | MARBLE CITY FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/12/2015
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 7347 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-5714
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Country | US
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Telephone | 865-766-2081
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Fax |
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Provider Business Mailing Address
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Address Line | 7347 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-5714
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Country | US
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Telephone | 865-766-2081
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. JASON BLOOM
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Credential | D.C.
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Telephone | 865-766-2081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2790
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License Number State | TN
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