Healthcare Provider Details

I. General information

NPI: 1053698217
Provider Name (Legal Business Name): EXODUS CHIROPRACTIC OF FRANKLIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SEABOARD LN SIDE B
FRANKLIN TN
37067-8218
US

IV. Provider business mailing address

120 SEABOARD LN SIDE B
FRANKLIN TN
37067-8218
US

V. Phone/Fax

Practice location:
  • Phone: 615-435-3654
  • Fax: 615-628-8044
Mailing address:
  • Phone: 615-435-3654
  • Fax: 615-628-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number2520
License Number StateTN

VIII. Authorized Official

Name: DR. CHRISTOPHER M BOLES
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 615-435-3654