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General NPI Number Information
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NPI Number | 1417612623
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Entity Type | Organization
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Legal Business Name | BRIGHTLIFE OF KNOXVILLE
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 190B MARKET PLACE BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37922-2337
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Country | US
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Telephone | 865-288-4568
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Fax | 865-288-4570
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Provider Business Mailing Address
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Address Line | 190B MARKET PLACE BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37922-2337
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Country | US
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Telephone | 865-288-4568
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Fax | 865-288-4570
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Authorized Official
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Title or Position | OWNER
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Name | ANNETTE RAE BURLISON
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Credential |
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Telephone | 865-288-4568
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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 |
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License Number State |
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