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NPI Code Detail

MEDICARE: DAVID GRANT BROGDON D.C.

MEDICARE: DAVID GRANT BROGDON D.C.
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
1111N00000XChiropractor1330TN

General Provider Information

NPI Number : 1811196413
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID GRANT BROGDON D.C.
Provider Business Mailing Address
First Line : 1471 N MACK SMITH RD
Second Line :
City : EAST RIDGE
State : TN
Zip : 37412-3947
Country : US
Telephone Number : 423-485-8480
Fax Number : 423-485-8481
Provider Business Practice Location Address
First Line : 1471 N MACK SMITH RD
Second Line :
City : EAST RIDGE
State : TN
Zip : 37412-3947
Country : US
Telephone Number : 423-485-8480
Fax Number : 423-485-8481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2007
Last Update Date : 07/13/2007

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Directions to “ DAVID GRANT BROGDON D.C.” Practice Location

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