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General NPI Number Information
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NPI Number | 1669947503
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Entity Type | Organization
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Legal Business Name | KNOX CLINIC CORP
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | 834 N SEMINARY ST STE 102
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City | GALESBURG
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State | IL
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Zip | 61401-2897
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Country | US
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Telephone | 309-342-0194
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Fax | 309-341-2202
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Provider Business Mailing Address
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Address Line | PO BOX 5009
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City | BRENTWOOD
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State | TN
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Zip | 37024-5009
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Country | US
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Telephone | 615-221-3851
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SOPHIA ARWOOD
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Credential |
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Telephone | 615-221-3851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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