Healthcare Provider Details

I. General information

NPI: 1881025997
Provider Name (Legal Business Name): DRESDEN CHIROPRACTIC AND PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2013
Last Update Date: 11/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E LOCUST ST
DRESDEN TN
38225-1467
US

IV. Provider business mailing address

PO BOX 300
DRESDEN TN
38225-0300
US

V. Phone/Fax

Practice location:
  • Phone: 731-364-6060
  • Fax:
Mailing address:
  • Phone: 731-364-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1895
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1869
License Number StateTN

VIII. Authorized Official

Name: KENNETH SPRINGER
Title or Position: MEMBER MANAGER
Credential: PT
Phone: 731-571-1375