| NPI | 1932528338 |
|---|---|
| Doing Business As | PROVISION SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | KEVIN SPROUSE Owner 865-309-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TN 2248) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-04-14 |