Provider Demographics
NPI:1669947503
Name:KNOX CLINIC CORP
Entity type:Organization
Organization Name:KNOX CLINIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-3851
Mailing Address - Street 1:PO BOX 5009
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-5009
Mailing Address - Country:US
Mailing Address - Phone:615-221-3851
Mailing Address - Fax:
Practice Address - Street 1:834 N SEMINARY ST STE 102
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2897
Practice Address - Country:US
Practice Address - Phone:309-342-0194
Practice Address - Fax:309-341-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies