MEDICARE: THE CHIRO PLACE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2859	TN

General Provider Information

NPI Number	:	1013397181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CHIRO PLACE PLLC

Provider Business Mailing Address
First Line	:	3615 S HOUSTON LEVEE RD
Second Line	:	STE 110
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-9192
Country	:	US
Telephone Number	:	901-221-7173
Fax Number	:

Provider Business Practice Location Address
First Line	:	3615 S HOUSTON LEVEE RD
Second Line	:	STE 110
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-9192
Country	:	US
Telephone Number	:	901-221-7173
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/OWNER
Name	:	BRITTANY A KASPRACK
Credential	:
Telephone Number	:	901-371-1523

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	06/04/2015

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