Organization
JCK HOLDINGS LLC
Active
Other names
Square One Restorative Health
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA L MCCLOUD (ADMINISTRATOR)
(865) 219-5926
Entity
Organization
Contact information
Practice address
2270 SUTHERLAND AVENUE, KNOXVILLE, TN 37919
(865) 219-5926
(865) 951-2972
Mailing address
2270 SUTHERLAND AVE, KNOXVILLE, TN 37919-2331
(865) 219-5926
(865) 951-2972
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/25/2017
Last updated
07/21/2022
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