MEDICARE: WORTHINGTON CHIROPRACTIC 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

General Provider Information

NPI Number	:	1942047683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORTHINGTON CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	3963 ALTRURIA RD
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38135-5113
Country	:	US
Telephone Number	:	901-519-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	7174 STAGE RD STE 111
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38133-8954
Country	:	US
Telephone Number	:	901-519-7777
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JARED WORTHINGTON
Credential	:	DC
Telephone Number	:	901-519-7777

Provider Enumeration Date	:	07/10/2024
Last Update Date	:	07/10/2024

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