Evolve 865
NPI #1760189443 in Lenoir City, Tennessee
Provider Information
- NPI Number
- 1760189443
- Entity Type
- Organization
- Organization Name
- Evolve 865
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Feb 13, 2023
- Last Updated
- Feb 13, 2023
Practice Location
- Address
- 460 MEDICAL PARK DR STE 102
- City
- Lenoir City
- State
- Tennessee
- ZIP Code
- 37772-6469
- Phone
- (865) 384-4865
Authorized Official
- Name
- MRS. JILL DYVON LARSON, APN
- Title
- OWNER/NP
- Phone
- (865) 384-4865
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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