Healthcare Provider Details

I. General information

NPI: 1376837674
Provider Name (Legal Business Name): 3 ELEMENTS CHIROPRACTIC & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 DAVENPORT DR STE 200B
FRANKLIN TN
37069-4204
US

IV. Provider business mailing address

1109 DAVENPORT DR STE 200B
FRANKLIN TN
37069-4204
US

V. Phone/Fax

Practice location:
  • Phone: 615-878-3485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2414
License Number StateTN

VIII. Authorized Official

Name: DR. KIMBERLY GERBERS BRENGLE
Title or Position: OWNER
Credential: DC
Phone: 615-878-3485