Healthcare Provider Details

I. General information

NPI: 1689611972
Provider Name (Legal Business Name): DAVID TOY RAHAMUT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3771 GEORGETOWN RD NW
CLEVELAND TN
37312-2565
US

IV. Provider business mailing address

3771 GEORGETOWN RD NW
CLEVELAND TN
37312-2565
US

V. Phone/Fax

Practice location:
  • Phone: 423-790-1425
  • Fax: 423-790-1426
Mailing address:
  • Phone: 423-790-1425
  • Fax: 423-790-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC1813
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: