Provider Demographics
NPI:1831825504
Name:TOTAL RECOVERY MIND & BODY PLLC
Entity type:Organization
Organization Name:TOTAL RECOVERY MIND & BODY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:SHREVE
Authorized Official - Last Name:KAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-281-5480
Mailing Address - Street 1:5724 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-2224
Mailing Address - Country:US
Mailing Address - Phone:865-281-5480
Mailing Address - Fax:865-281-5484
Practice Address - Street 1:5724 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-2224
Practice Address - Country:US
Practice Address - Phone:865-281-5480
Practice Address - Fax:865-281-5484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty