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Chiropractic Providers Chiropractor

Provider NPI: 1467717181

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 615-599-8828  Fax: --

Business Mailing Address:
Tel: 615-599-8828  Fax: --

NPI Information:
NPI: 1467717181
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N111N00000XChiropractic Providers
N111NI0900XChiropractic Providers
Y111NS0005XChiropractic Providers
N111NR0400XChiropractic Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 111NS0005X





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