Organization
ECHELON SPORTS MEDICINE, PLLC
Active
Other names
Provision Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN SPROUSE D.O. (OWNER)
(865) 309-5551
Entity
Organization
Contact information
Practice address
1400 DOWELL SPRINGS BLVD, SUITE 140, KNOXVILLE, TN 37909-2456
(865) 232-1408
Mailing address
510 OAKHURST DR, KNOXVILLE, TN 37919-6643
(865) 309-5551
(865) 381-1967
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2248
TN
Other
Enumeration date
04/14/2014
Last updated
04/14/2014
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