MEDICARE: MOSELEY CHIROPRACTIC CLINIC

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	379	TN

General Provider Information

NPI Number	:	1285971945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSELEY CHIROPRACTIC CLINIC

Provider Business Mailing Address
First Line	:	220 CHILTON ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-2929
Country	:	US
Telephone Number	:	615-832-2056
Fax Number	:	615-832-2057

Provider Business Practice Location Address
First Line	:	220 CHILTON ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-2929
Country	:	US
Telephone Number	:	615-832-2056
Fax Number	:	615-832-2057

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM RUSSELL MOSELEY
Credential	:	D.C.
Telephone Number	:	615-832-2056

Provider Enumeration Date	:	01/14/2013
Last Update Date	:	01/14/2013

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