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General NPI Number Information
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NPI Number | 1982938122
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Entity Type | Organization
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Legal Business Name | CIRCUIT ATHLETICS LLC
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Dates
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Enumeration Date | 09/21/2009
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Last Update Date | 09/21/2009
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Provider Practice Location Address
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Address Line | 1865B ASHLAND CITY RD
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City | CLARKSVILLE
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State | TN
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Zip | 37043-6447
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Country | US
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Telephone | 931-552-2804
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Fax | 931-552-2861
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Provider Business Mailing Address
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Address Line | 1865B ASHLAND CITY RD
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City | CLARKSVILLE
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State | TN
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Zip | 37043-6447
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Country | US
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Telephone | 931-552-2804
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Fax | 931-552-2861
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES HOSKINS
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Credential | LPN
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Telephone | 931-552-2804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number |
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License Number State |
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